Correlation and influencing factors analysis of incision infection and gastrointestinal hormone levels in elderly patients undergoing laparoscopic gastrointestinal tumor surgery
Objective To explore the correlation between incision infection and gastrointestinal hormone levels in elderly patients undergoing laparoscopic gastrointestinal tumor surgery,and to analyze the influencing factors of incision infection.Methods A retrospective analysis was conducted on the clinical data of 40 elderly patients with incision infection after laparoscopic gastrointestinal tumor surgery admitted to our hospital in the past 5 years.They were divided into an infection group,and another 40 elderly patients who did not experience postoperative incision infection or other complications during the same period were selected as the non infection group.Compare the levels of motilin and gastrin before and after surgery in two groups,use Spearman correlation analysis to analyze the correlation between incision infection and gastrointestinal hormone levels before and after surgery,and perform Logistic regression analysis on the risk factors for incision infection.Results There was no significant difference in the levels of motilin and gastrin between the infection and non infection groups on the first day before surgery(P＞0.05).However,on the first day after surgery,both groups showed a decrease in motilin and gastrin levels.The levels of motilin(168.33±28.68)ng/L and gastrin(121.73±26.11)ng/L in the infection group were lower than those in the non infection group(P＜0.05);the Spearman correlation analysis method was used to analyze the correlation between incision infection and preoperative and postoperative gastrointestinal hormone levels.The results showed that there was no significant correlation between gastric motility and gastrin levels and incision infection on the first day before surgery(P＞0.05),while there was a negative correlation between gastric motility and gastrin levels and incision infection on the first day after surgery(P＜0.05);there was no significant difference between the infection group and the non infection group in terms of gender,age,hypertension,hyperlipidemia,tumor location,and joint organ resection(P＞0.05).The rate of infection combined with diabetes was 37.50%,the obstruction rate was 20.00%,and the stoma rate was 32.50%higher than that of the non infection group.The total hospital stay time was(25.24±3.11)days,the operation time was(133.53±11.51)minutes,the intraoperative bleeding volume was(425.52±38.45)mL,the intraoperative fluid replacement volume was(2144.63±137.35)mL,the postoperative drainage time was(12.42±2.34)days,and the postoperative drainage volume was(196.24±25.21)mL,all higher than that of the non infection group(P＜0.05);on postoperative day 1,gastric motility(95%CI:0.652-0.894,OR:0.764),gastrin(95%CI:1.236-11.326,OR:3.741),concomitant obstruction(95%CI:0.043-0.464,OR:0.141),stoma(95%CI:1.086-1.305,OR:1.191),length of hospital stay(95%CI:0.916-0.984,OR:0.949),surgical time(95%CI:1.018-1.235,OR:1.121),intraoperative bleeding volume(95%CI:0.827-0.961,OR:0.891),and intraoperative fluid replacement volume(95%CI:1.076-1.235,OR:1.153),postoperative drainage time(95%CI:1.321-3.564,OR:1.726),and postoperative daily drainage volume(95%CI:1.353-5.782,OR:2.462)are independent risk factors for incision infection in elderly patients undergoing laparoscopic gastrointestinal tumor surgery(P＜0.05).Conclusion Incision infection in elderly patients undergoing laparoscopic gastrointestinal tumor surgery is closely related to gastrointestinal hormone levels,and the high-risk groups for postoperative incision infection include lower levels of motilin and gastrin on postoperative day 1,concomitant obstruction,stoma,length of hospital stay,surgical time,intraoperative bleeding volume,intraoperative fluid replacement volume,postoperative drainage time,and increased drainage volume on the day of surgery.
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