乳腺癌根治术后患者切口感染病原学特点及其危险因素分析

Etiological Characteristics and Risk Factors of Incision Infection in Patients after Radical Mastectomy

谢树花¹

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作者信息

1. 赣州市肿瘤医院急诊综合科江西赣州 341000
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摘要

目的:探讨乳腺癌根治术后患者切口感染病原学特点及其危险因素分析.方法:选取2021年1月—2023年12月在赣州市肿瘤医院行根治性切除术治疗的110例乳腺癌患者作为研究对象,统计患者切口感染发生率及病原菌分布特征,并分析影响切口感染发生的危险因素.结果:纳入的110例乳腺癌根治术患者术后共发生切口感染14例,发生率为12.73％;共检出病原菌25株,其中以革兰阴性菌为主,占比60.00％,革兰阳性菌、真菌占比分别为32.00％和8.00％.单因素分析显示,不同年龄、合并糖尿病、手术时间、引流管留置时间、术后预防性应用抗生素、辅助化疗患者术后切口感染发生率比较,差异均有统计学意义(P<0.05);不同体重指数、合并高血压、肿瘤直径、国际通用肿瘤(TNM)分期、术中出血量、引流量患者术后切口感染发生率比较,差异均无统计学意义(P>0.05).多因素logistic回归分析显示,年龄≥60岁、手术时间≥2 h、引流管留置时间≥7 d、辅助化疗是患者术后切口感染发生的危险因素(P<0.05).结论:乳腺癌根治术后患者切口感染病原菌以革兰阴性菌为主,年龄≥60岁、手术时间≥2 h、留置引流时间≥7 d、辅助化疗是其主要危险因素,临床中应加强针对性防控,以降低切口感染发生率.

Abstract

Objective:To investigate the etiological characteristics and risk factors of incision infection in patients after radical mastectomy. Method:A total of 110 breast cancer patients who underwent radical mastectomy in Ganzhou Cancer Hospital from January 2021 to December 2023 were selected as the study objects. The incidence of incisional infection and the distribution characteristics of pathogenic bacteria were analyzed,and the risk factors affecting the occurrence of incisional infection were analyzed. Result:Among the 110 patients who underwent radical mastectomy,a total of 14 cases developed incision infection,with an incidence of 12.73％;a total of 25 strains of pathogenic bacteria were detected,among which Gram-negative bacteria accounted for 60.00％,Gram-positive bacteria and fungi accounted for 32.00％ and 8.00％ respectively. Univariate analysis showed that there were statistically significant differences in the incidence of postoperative incision infection among patients with different ages,diabetes mellitus,operation time,drainage tube retention time,postoperative prophylactic antibiotics and adjuvant chemotherapy (P<0.05). There were no significant differences in the incidence of postoperative incision infection among patients with different body mass index,combined hypertension,tumor diameter,tumor node metastasis (TNM) classification,intraoperative blood loss and drainage volume (P>0.05). Multivariate logistic regression analysis showed that age ≥60 years old,operation time ≥2 h,drainage tube retention time ≥7 d and adjuvant chemotherapy were the risk factors for postoperative incision infection (P<0.05). Conclusion:The pathogenic bacteria of incision infection in patients after radical mastectomy are mainly Gram-negative bacteria,the age ≥60 years,the operation time ≥2 h,the indentation and drainage time ≥7 d,and adjuvant chemotherapy are the main risk factors. Targeted prevention and control should be strengthened in clinical practice to reduce the incidence of incision infection.

关键词

乳腺癌/根治性切除术/切口感染/病原学特征/危险因素

Key words

Breast cancer/Radical mastectomy/Incision infection/Etiological characteristics/Risk factor

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出版年

2024

中国医学创新

中国保健协会

中国医学创新

影响因子：1.706

ISSN：1674-4985

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