目的分析肝癌患者术后发生手术切口感染的影响因素,为更好的防治手术切口感染提供科学依据。方法回顾性分析157例2009年3月-2013年1月在医院治疗的肝癌手术患者,根据其术后是否发生手术切口感染将其分为病例组和对照组,单因素分析采用X^2检验,采用logistic回归分析的方法研究患者发生手术切口感染的影响因素。结果切口感染在术后〈3d者1例占0.6%、3~7d6例占3.8%、〉7d者10例占6.4%;病例组手术时间长、出血量大、肝门阻断,发生切口感染率高;高龄(0R=1.782,95%CI=1.194~2.660)、术前患有糖尿病(OR=1.301,95%CI=1.095~1.546)、低蛋白血症(OR=1.829,95%CI=1.427~2.344)、肝硬化(OR=2.011,95%CI:1.095~3.693)、术中出血量〉800ml(OR=1.071,95%CI=1.024~1.120)、手术时间〉240min(OR=1.829,95%CI=1.427~2.344)、肝门阻断(0IR=1.765,95%CI=1.024~3.042)是导致患者术后发生手术切口感染的危险因素。结论高龄、术前患有糖尿病、低蛋白血症、肝硬化、手术时间长、术中出血量大是患者术后发生切口感染的危险因素,应采取有效措施监护高危患者,改善患者预后。
OBJECTIVE To analyze the influence factor of postoperative surgical site infection in patients with liver cancer, and provide scientific basis for better prevention of surgical site infection. METHODS A retrospective anal-ysis was conducted on 157 patients with liver cancer treated in our hospital from Mar. 2009 to Jan. 2013, and were divided into case group and control group according to the occurrence of incision infection. The single factor analysis was performed using the 2 test and the influencing factors of surgical site infection were investigated u- sing logistic regression analysis. RESULTS There was one patient developing incision infection within 3 days (0.6%), 6 patients (3.80%) in 3 to 7 days and 10 patients (6.4%) more than 7 days. The patients in the case group had a high rate of incision infection due to long operation time, large blood loss and hepatic portal occlusion. Advanced age(OR= 1. 782,95 % CI = 1. 194 - 2. 660), preoperative diabetes (OR = 1. 301, 95 % CI = 1. 095 -1. 546), hypoalbuminemia (OR=1. 829, 95 %CI= 1. 427-2. 344), cirrhosis of the liver(OR = 2. 011, 95 % CI= 1. 095%3. 693), blood loss 〉800 ml during the operation(OR=1. 071, 95%CI=1. 024-1. 120), surgical time〉 240 min(OR=1. 829,95%CI=1. 427%2. 344) and hepatic portal occlusion(OR= 1. 765,95%CI=1. 024%3. 042) were risk factors of postoperative surgical site infection in patients. CONCLUSION Advanced age, preoperative diabetes, hypoalbuminemia, cirrhosis of the liver, large blood loss during the operation, surgical time are risk factors of postoperative surgical site infection in patients. Effective measures should be taken for high-risk patients in order to improve the prognosis of patients.