摘要
目的 分析结直肠癌肝脏转移患者同期手术后发生腹腔感染的危险因素.方法 回顾性分析2013年1月至2023年6月行结直肠癌肝脏转移同期手术患者的临床资料,采用单因素分析及多因素logistic回归分析结直肠癌肝脏转移同期手术后发生腹腔感染的危险因素.结果 共纳入115例结直肠癌肝脏转移同期手术治疗的患者,其中感染组28例,占比24.3％;患者的性别、年龄、BMI、糖尿病、高血压、新辅助化疗、原发肿瘤位置、原发肿瘤病理类型、原发肿瘤直径、T≥4、N≥1、肝转移灶直径、原发灶转移灶切除顺序、腹腔镜手术、肠造口、手术时间,感染组和非感染组相比差异无统计学意义(P＞0.05);单因素分析结果显示,术中肝门阻断、肝脏组织切除范围大、出血量≥200 ml、输血、术后总蛋白、术后白蛋白水平,感染组和非感染组相比差异有统计学意义(P＜0.05);多因素Logistic回归分析结果显示,术中肝门阻断、出血量≥200 ml、术后白蛋白水平低下为结直肠癌肝脏转移患者同期手术后发生腹腔感染的独立危险因素(P＜0.05).结论 结直肠癌肝脏转移患者同期手术后发生腹腔感染受多种因素影响,避免肝门阻断、减少出血量和提高术后白蛋白水平,可能对减少腹腔感染有一定的临床意义.
Abstract
Objective To analyze the risk factors of intra-abdominal infection in patients receiving colorectal cancer resection with simultaneous liver metastasis resection.Methods Clinical data of patients receiving colorectal cancer resection with simultaneous liver metastasis resection from January 2013 to June 2023 were retrospectively analyzed.Univariate analysis and multivariate logistic re-gression were used to analyze the risk factors of intra-abdominal infection after concurrent operation for liver metastasis of colorectal cancer.Results A total of 115 patients with liver metastasis of colorectal cancer treated with concurrent surgery were included,inclu-ding 28 patients in the infection group,accounting for 24.3％.There was no significant difference in gender,age,BMI,diabetes,hy-pertension,neoadjuvant chemotherapy,primary tumor location,pathological type of primary tumor,primary tumor diameter,T≥4,N≥1,liver metastasis diameter,primary metastasis resection sequence,laparoscopic surgery,enterostomy and operation time between infected group and non-infected group(P＞0.05).The results of univariate analysis showed that there were significant differences be-tween infected group and non-infected group in hepatic portal occlusion,large scope of liver tissue resection,blood loss ≥ 200 ml,blood transfusion,postoperative total protein and postoperative albumin level(P＜0.05).Multivariate Logistic regression analysis showed that hepatic portal occlusion,blood loss ≥ 200 ml and postoperative albumin level were independent risk factors for postopera-tive intra-abdominal infection in patients receiving colorectal cancer resection with simultaneous liver metastasis resection(P＜0.05).Conclusion The intra-abdominal infection in patients receiving colorectal cancer resection with simultaneous liver metastasis resection is affected by many factors.Avoiding hepatic portal occlusion,reducing blood loss and improving postoperative albumin levels may have certain clinical significance in reducing intra-abdominal infection.
基金项目
安徽医科大学科研基金(2022xkj171)
安徽医科大学第二附属医院转化医学研究科研基金(2022ZHYJ15)
NETL
NSTL
维普
万方数据