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目的探讨腹腔镜下结直肠癌术后感染并发症的特点及危险因素,以针对性采取措施降低感染率。方法回顾性分析2011年2月—2016年2月在新昌县人民医院行腹腔镜下结直肠癌手术患者204例,对术后感染并发症特点进行归纳,并从年龄、糖尿病、肺部疾患、手术时间、中转手术、TNM分期、体质量指数、术中出血量等方面对感染进行危险因素分析。结果腹腔镜下结直肠癌术后感染24例,发生率为11.76%,感染分布中腹腔脓肿发生率最高,比率为41.67%,切口感染、院内获得性肺炎、下尿路感染、导管相关感染发生率分别为29.17%、12.50%、8.33%、8.33%,腹腔脓肿和其他感染比较差异有统计学意义(P<0.05);危险因素有存在肺部疾患、手术时间长(>180 min)、存在糖尿病(P<0.05),而与性别、年龄、中转手术、体质量指数、术中出血量、TNM分期无关(P>0.05);其中手术时间、糖尿病、肺部疾患是腹腔镜结直肠癌术后感染独立危险因素(Wald值分别为9.679、10.121、13.893,P值分别为0.011、0.014、0.025)。结论腹腔镜下结直肠癌术后感染以腹腔脓肿最常见,其中手术时间、糖尿病、肺部疾患是腹腔镜结直肠癌术后感染独立危险因素,在临床上要加强观察。
Objective To investigate the characteristics and risk factors of postoperative complications of laparoscopic surgery for colorectal cancer and to take targeted measures to reduce the infection rate. Methods A retrospective analysis of 204 patients undergoing laparoscopic colorectal cancer surgery in Xinchang People’s Hospital from February 2011 to February 2016 was performed to summarize the characteristics of postoperative infection complications and to analyze the characteristics of postoperative complications including age, diabetes, pulmonary diseases, Operative time, transit surgery, TNM staging, body mass index, intraoperative blood loss and other aspects of risk factors for infection. Results The incidence of postoperative infection of colorectal cancer in laparoscopic group was 24 (11.76%). The incidence of intraperitoneal abscess in infection distribution was the highest (41.67%). Incisional infection, nosocomial pneumonia, lower urinary tract infection and catheter-related infection occurred (P <0.05). The risk factors were pulmonary diseases, the operation time was longer (> 180 min), and the existence rate was higher than that of the control group (29.17%, 12.50%, 8.33%, 8.33% (P <0.05), but not related to gender, age, transit surgery, body mass index, intraoperative blood loss and TNM stage (P> 0.05). Among them, operation time, diabetes mellitus, Post-infection independent risk factors (Wald values were 9.679,10.121,13.893, P values were 0.011,0.014,0.025, respectively). Conclusions Laparoscopic surgery for postoperative colorectal cancer is the most common type of intraperitoneal abscess. The operation time, diabetes and lung diseases are independent risk factors of postoperative infection of laparoscopic colorectal cancer. Clinical observation should be strengthened.