泌尿外科患者术后应激性高血糖对术后感染的影响分析
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摘要
目的探讨泌尿外科患者术后应激性高血糖对术后感染的影响。方法 2018年1—12月间方便选择302例该院泌尿外科手术患者,对患者术后血糖水平与其术后感染情况予以对比,并记录患者术后感染发生位置及病原菌情况。结果泌尿外科患者中发生感染14例,占比4.64%。呼吸系统、泌尿系统、消化系统、切口感染占比分别为42.86%、28.57%、21.43%、7.14%,A、B、C、D级感染发生率分别为14.29%、28.57%、35.71%、21.43%。检验结果显示病原菌包括大肠埃希菌、粪肠球菌、金黄色葡萄球菌、溶血葡萄球菌、肺炎型肺炎克雷伯氏菌、嗜水气单胞菌、表皮葡萄球菌、鲍曼氏不动杆菌、假单胞菌属,其中大肠埃希菌、粪肠球菌、金黄色葡萄球菌所占比例较高,分别为35.29%、17.65%、11.76%。A、B级血糖感染发生比例(2.24%)低于C、D级(23.53%),组间差异有统计学意义(χ~2=30.936 9,P=0.000 0<0.05)。结论泌尿外科患者术后发生应激性高血糖会增加其感染率,临床中应根据患者血糖情况予以预防性综合干预,降低患者术后感染发生比例。
Objective To investigate the effect of postoperative stress hyperglycemia on postoperative infection in patients with urology. Methods A total of 302 patients undergoing urologic surgery were enrolled. The patients were convenient enrolled between January 1, 2018 and December 31, 2018. The postoperative blood glucose levels were compared with postoperative infections, and the location of postoperative infections and pathogens was recorded. Results Fourteen cases of infection occurred in urological patients, accounting for 4.64%. Respiratory system, urinary system, digestive system, and incision infection accounted for 42.86%, 28.57%, 21.43%, and 7.14%, respectively. The incidence rates of A, B, C, and D infections were 14.29%, 28.57%, 35.71%, and 21.43%, respectively. The test results showed that the pathogens include Escherichia coli,Enterococcus faecalis, Staphylococcus aureus, Staphylococcus haemolyticus, Klebsiella pneumoniae, Aeromonas hydrophila,Staphylococcus epidermidis, Acinetobacter baumannii, Pseudomonas, in which Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus account for a relatively high proportion, which were 35.29%, 17.65%, and 11.76%, respectively. The proportion of grade A and B blood glucose infections(2.24%) was lower than that of C and D grades(23.53%),between the groups the difference was statistically significant(χ~2=30.936 9,P =0.000 0 <0.05). Conclusion Postoperative stress hyperglycemia in urological patients will increase the infection rate. In clinical practice, preventive compre hensive intervention should be based on the patient's blood glucose, which will reduce the proportion of postoperative infection.
Objective To investigate the effect of postoperative stress hyperglycemia on postoperative infection in patients with urology. Methods A total of 302 patients undergoing urologic surgery were enrolled. The patients were convenient enrolled between January 1, 2018 and December 31, 2018. The postoperative blood glucose levels were compared with postoperative infections, and the location of postoperative infections and pathogens was recorded. Results Fourteen cases of infection occurred in urological patients, accounting for 4.64%. Respiratory system, urinary system, digestive system, and incision infection accounted for 42.86%, 28.57%, 21.43%, and 7.14%, respectively. The incidence rates of A, B, C, and D infections were 14.29%, 28.57%, 35.71%, and 21.43%, respectively. The test results showed that the pathogens include Escherichia coli,Enterococcus faecalis, Staphylococcus aureus, Staphylococcus haemolyticus, Klebsiella pneumoniae, Aeromonas hydrophila,Staphylococcus epidermidis, Acinetobacter baumannii, Pseudomonas, in which Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus account for a relatively high proportion, which were 35.29%, 17.65%, and 11.76%, respectively. The proportion of grade A and B blood glucose infections(2.24%) was lower than that of C and D grades(23.53%),between the groups the difference was statistically significant(χ~2=30.936 9,P =0.000 0 <0.05). Conclusion Postoperative stress hyperglycemia in urological patients will increase the infection rate. In clinical practice, preventive compre hensive intervention should be based on the patient's blood glucose, which will reduce the proportion of postoperative infection.
引文
[1]孙同欣,杨丽娜,杨蓓,等.泌尿外科患者手术后应激性高血糖对感染的影响研究[J].中华医院感染学杂志,2016,26(1):123-124,127.
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[6]Oren E,Fiero MH,Barrett E,et al.Detection of latent tuberc ulosis infection among migrant farmworkers along the US-Mexico border[J].Bmc Infectious Diseases,2016,16(1):630.
[7]周锐,王建祥,沈俊,等.高渗盐水对结肠癌患者术后应激性高血糖的作用[J].内科急危重症杂志,2016,22(4):287-289.
[8]何瑞玲,陈洁,曾晖,等.不同血糖控制方案对脑出血术后应激性高血糖患者预后的影响[J].岭南急诊医学杂志,2017,22(2):137-138,41.
[9]Ogechi NRI,Omalathebu O J.Changes in blood sugar lev els of rats experimentally infected withTrypanosoma brucei and treated with imidocarb dipropionate and diminazene aceturate[J].海岸生命医学杂志:英文版,2016,4(1):21-23.
[10]Regendanz P.Pathogenicity of Trypanosoma Lewisi and Blood Sugar in Infections with Trypanosoma Lewisi and Bartonella Muris Ratti[J].Annals of Tropical Medicine&Parasitology,1929,23(4):523-526.
[11]龚箭,张卫彬,武云飞,等.自拟大黄牡丹方剂对腹部大手术后应激性高血糖患者血糖指标、胃肠道黏膜屏障功能及临床结局的影响[J].现代中西医结合杂志,2017(7):91-93.
[12]夏海娜,牛桂林,历冰,等.非糖尿病胃癌患者手术应激性高血糖对术后感染及预后的影响分析[J].中华医院感染学杂志,2017(12):2740-2743.
[2]莫敬柏,刘明,高兴林.泌尿外科患者手术后应激性高血糖对感染的影响研究[J].临床医药文献电子杂志,2017(72):14071-14071.
[3]张然,许勤,陈丽,等.血糖不稳定指数对胃癌术后应激性高血糖患者预后的预测价值[J].江苏医药,2016,42(1):20-22.
[4]Chang PJ,Yang YH,Chen PC,et al.Diabetes and risk of Kaposi's sarcoma:effects of high glucose on reactivation and infection of Kaposi's sarcoma-associated herpesvirus[J].Oncotarget,2017,8(46):80595-80611.
[5]张凯波.应激性高血糖对上腹手术患者预后的影响[J].河南医学高等专科学校学报,2017,29(6):522-524.
[6]Oren E,Fiero MH,Barrett E,et al.Detection of latent tuberc ulosis infection among migrant farmworkers along the US-Mexico border[J].Bmc Infectious Diseases,2016,16(1):630.
[7]周锐,王建祥,沈俊,等.高渗盐水对结肠癌患者术后应激性高血糖的作用[J].内科急危重症杂志,2016,22(4):287-289.
[8]何瑞玲,陈洁,曾晖,等.不同血糖控制方案对脑出血术后应激性高血糖患者预后的影响[J].岭南急诊医学杂志,2017,22(2):137-138,41.
[9]Ogechi NRI,Omalathebu O J.Changes in blood sugar lev els of rats experimentally infected withTrypanosoma brucei and treated with imidocarb dipropionate and diminazene aceturate[J].海岸生命医学杂志:英文版,2016,4(1):21-23.
[10]Regendanz P.Pathogenicity of Trypanosoma Lewisi and Blood Sugar in Infections with Trypanosoma Lewisi and Bartonella Muris Ratti[J].Annals of Tropical Medicine&Parasitology,1929,23(4):523-526.
[11]龚箭,张卫彬,武云飞,等.自拟大黄牡丹方剂对腹部大手术后应激性高血糖患者血糖指标、胃肠道黏膜屏障功能及临床结局的影响[J].现代中西医结合杂志,2017(7):91-93.
[12]夏海娜,牛桂林,历冰,等.非糖尿病胃癌患者手术应激性高血糖对术后感染及预后的影响分析[J].中华医院感染学杂志,2017(12):2740-2743.