颈部吻合食管癌切除术手术部位感染危险因素分析及预测模型研究

Risk factors and prediction of surgical site infections in esophageal cancer patients after esophagectomy with cervical anastomosis

  • 摘要: 目的 分析颈部吻合食管癌切除术手术部位感染的危险因素,建立感染预测模型,为预防控制感染提供依据。方法 选取2010年1月-2015年5月医院行颈部吻合食管癌切除术患者711例,收集患者临床资料、分析其感染因素。结果 146例患者发生感染,感染率为20.53%;经logistic回归分析显示,术后发生吻合口瘘、术前0.5~2 h未使用抗菌药物、术后0~3 d血清白蛋白<30 g/L、术后0~3 d血清前白蛋白<20 g/L是手术部位感染的独立危险因素(P<0.05),根据以上结果进一步建立预测模型,经评估预测价值较高(AUC=0.8993)。结论 本研究筛选了颈部吻合食管癌切除术手术部位感染的独立危险因素,并建立了手术部位感染预测模型,为实现手术部位精准感控提供依据及方法。

     

    Abstract: OBJECTIVE To investigation related factors of surgical site infections after esophagectomy with cervical anastomosis of esophageal cancer patients, and establish infection prediction model, so as to provide evidence for prevention and control of infections. METHODS A total of 711 esophageal cancer patients who had undergone esophagectomies with cervical anastomosis from Jan.2010 to May 2015 were selected. The clinical data of patients were collected and the infection factors were analyzed. RESULTS Among the 711 patients, 146(20.53%) had developed surgical site infections (SSI). Logistic regression analysis showed that anastomotic leakage, antimicrobial prophylaxis in 0.5~2 h before surgery,postoperative hypoalbuminemia<30 g/L and hypoprealbuminemia<20 g/L at 0~3 d after surgery were independent risk factors for SSI (P<0.05). A prediction model containing these variables was developed and had a good predictive value(AUC=0.8993). CONCLUSION The independent risk factors for SSI after esophagectomy with cervical anastomosis of esophageal cancer patients are screened, and a prediction model is established, which can provide basis and method for precise control of SSI.

     

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