胃癌患者胃大部切除术后感染的危险因素及护理对策
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摘要
目的探讨胃癌患者胃大部切除术后感染的危险因素及护理对策。方法选取2017年10月至2018年12月间渭南市中心医院收治的111例行胃大部切除术的胃癌患者,按照是否发生术后感染分为感染组(40例)和对照组(71例),采用单因素分析和Logistic多因素回归分析术后感染的危险因素,并提出针对性护理干预措施。结果患者共有40例(36. 0%)发生感染,包括肺部感染14例(35. 0%)、腹腔感染10例(25. 0%)、切口感染9例(22. 5%)、尿路感染6例(15. 0%)和其他1例(2. 5%)。两组患者的年龄、体重指数、吸烟、糖尿病、肿瘤分期、白细胞水平、术前输血、消化性溃疡、术前使用抗生素和术后卧床时间比较,差异均有统计学意义(均P <0. 05)。患者年龄、肥胖、吸烟、糖尿病、病理分期为中晚期和术后卧床时间短为影响胃癌患者胃大部切除术后感染的危险因素,差异均有统计学意义(均P <0. 05)。结论针对胃癌患者胃大部切除术后感染的危险因素开展护理干预,能够有效降低患者术后感染概率,保证整体临床疗效。
Objective To investigate the risk factors and nursing strategies for infection in patients with gastric cancer after subtotal gastrectomy. Methods A retrospective analysis of 111 patients with gastric cancer who underwent partial gastrectomy at Weinan Central Hospital from October 2017 to December18,2018 was performed. According to whether or not postoperative infection occurred,the patients were divided into the infected group( 40 patients) and a control group( 71 patients). Univariate analysis and Logistic multivariate regression analysis were used to analyze risk factors for postoperative infection and targeted nursing interventions were proposed. Results The study found that infection occurred in 40 patients( 36. 0% s) including 14( 35. 0%) lung infection,10( 25. 0%) abdominal infection,9( 22. 5%) surgical incision,6( 15. 0%) urinary tract infection and 1( 2. 5%) other infection. There were significant differences in age,body mass index,smoking,diabetes,tumor stage,white blood cell level,preoperative blood transfusion,digestion ulcers,preoperative antibiotics,and postoperative bed rest between the two groups( all P < 0. 05),suggesting that they may be risk factors for infection in patients with gastric cancer after gastric resection. According to the results of Logistic multivariate regression analysis,age,obesity,smoking,diabetes,advanced pathological stage and postoperative bedtime were risk factors for infection in patients with gastric cancer after subtotal gastrectomy. Conclusion Nursing intervention for the risk factors of gastric cancer after gastric resection can effectively reduce the risk of postoperative infection so as to ensure the overall clinical efficacy.
Objective To investigate the risk factors and nursing strategies for infection in patients with gastric cancer after subtotal gastrectomy. Methods A retrospective analysis of 111 patients with gastric cancer who underwent partial gastrectomy at Weinan Central Hospital from October 2017 to December18,2018 was performed. According to whether or not postoperative infection occurred,the patients were divided into the infected group( 40 patients) and a control group( 71 patients). Univariate analysis and Logistic multivariate regression analysis were used to analyze risk factors for postoperative infection and targeted nursing interventions were proposed. Results The study found that infection occurred in 40 patients( 36. 0% s) including 14( 35. 0%) lung infection,10( 25. 0%) abdominal infection,9( 22. 5%) surgical incision,6( 15. 0%) urinary tract infection and 1( 2. 5%) other infection. There were significant differences in age,body mass index,smoking,diabetes,tumor stage,white blood cell level,preoperative blood transfusion,digestion ulcers,preoperative antibiotics,and postoperative bed rest between the two groups( all P < 0. 05),suggesting that they may be risk factors for infection in patients with gastric cancer after gastric resection. According to the results of Logistic multivariate regression analysis,age,obesity,smoking,diabetes,advanced pathological stage and postoperative bedtime were risk factors for infection in patients with gastric cancer after subtotal gastrectomy. Conclusion Nursing intervention for the risk factors of gastric cancer after gastric resection can effectively reduce the risk of postoperative infection so as to ensure the overall clinical efficacy.
引文
[1]赵洁,王晓丽,罗文文,等.胃癌患者胃大部切除术后感染的危险因素分析[J].中华医院感染学杂志,2013,23:1574-1576.
[2]肖昕,伍红英,张丽华.分级护理联合自我管理对胃癌患者根治术后感染和癌因性疲乏的影响[J].中国肿瘤临床与康复,2016,23:1497-1500.
[3]刘文玉.胃癌手术后发生感染的危险因素分析[J].中国肿瘤临床与康复,2013,20:879-881.
[4]陈建青.腹腔镜下胃大部切除术治疗胃癌术后感染的危险因素分析[J].中华医院感染学杂志,2013,23:2601-2603.
[5]郗洪庆,蓝炘,张珂诚,等.腹腔镜辅助远端胃癌根治术后并发症发生的危险因素分析[J].中华消化外科杂志,2018,17:182.
[6]吉国锋,陶有茂,李茁,等.胃癌患者行腹腔镜辅助远端胃切除术后感染的危险因素分析[J].吉林大学学报(医学版),2015,41:1076-1079.
[7]王恒恩,陈玉辉,裴艳蕾,等.术前不同营养状态对胃大部切除术后患者感染风险的影响[J].中国临床医生杂志,2017,45:65-68.
[8]吉国锋,陶有茂,马冲,等.老年胃癌患者腹腔镜胃切除术后感染的危险因素分析[J].中华医院感染学杂志,2015,25:3754-3756.
[9]李平,黄昌明,郑朝辉,等.胃癌根治术后非计划再手术对临床疗效的影响及其发生的危险因素分析(附4124例报告)[J].中华消化外科杂志,2018,17:564-570.
[2]肖昕,伍红英,张丽华.分级护理联合自我管理对胃癌患者根治术后感染和癌因性疲乏的影响[J].中国肿瘤临床与康复,2016,23:1497-1500.
[3]刘文玉.胃癌手术后发生感染的危险因素分析[J].中国肿瘤临床与康复,2013,20:879-881.
[4]陈建青.腹腔镜下胃大部切除术治疗胃癌术后感染的危险因素分析[J].中华医院感染学杂志,2013,23:2601-2603.
[5]郗洪庆,蓝炘,张珂诚,等.腹腔镜辅助远端胃癌根治术后并发症发生的危险因素分析[J].中华消化外科杂志,2018,17:182.
[6]吉国锋,陶有茂,李茁,等.胃癌患者行腹腔镜辅助远端胃切除术后感染的危险因素分析[J].吉林大学学报(医学版),2015,41:1076-1079.
[7]王恒恩,陈玉辉,裴艳蕾,等.术前不同营养状态对胃大部切除术后患者感染风险的影响[J].中国临床医生杂志,2017,45:65-68.
[8]吉国锋,陶有茂,马冲,等.老年胃癌患者腹腔镜胃切除术后感染的危险因素分析[J].中华医院感染学杂志,2015,25:3754-3756.
[9]李平,黄昌明,郑朝辉,等.胃癌根治术后非计划再手术对临床疗效的影响及其发生的危险因素分析(附4124例报告)[J].中华消化外科杂志,2018,17:564-570.