【摘要】：目的研究乳腺癌患者術(shù)后切口感染的病原菌分類及感染相關(guān)危險(xiǎn)因素,為預(yù)防術(shù)后切口感染提供參考依據(jù)。方法選取本院2012年10月至2015年10月收治的1242例行乳腺癌手術(shù)的患者為研究對(duì)象,對(duì)發(fā)生切口感染38例患者感染部位的分泌物進(jìn)行細(xì)菌學(xué)培養(yǎng)。統(tǒng)計(jì)患者術(shù)后切口感染發(fā)生率并對(duì)相關(guān)危險(xiǎn)因素進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果乳腺癌患者術(shù)后切口感染發(fā)生率為3.06%;切口感染部位檢出43株病原菌,其中革蘭陰性菌24株(55.8%),革蘭陽(yáng)性菌19株(44.2%);耐藥發(fā)生以革蘭陰性菌為主。統(tǒng)計(jì)顯示:年齡≥60歲(P=0.044)、臨床分期Ⅲ期以上(c TNM)(P=0.013)、行標(biāo)準(zhǔn)根治術(shù)或擴(kuò)大根治術(shù)(P=0.032)、營(yíng)養(yǎng)水平差(血清白蛋白35 g/L)(P=0.012)、伴有糖尿病(P=0.006)、外周血白細(xì)胞計(jì)數(shù)4×10~9個(gè)/L(P=0.001)、細(xì)胞免疫功能低下(外周血T細(xì)胞總數(shù)及CD4~+T細(xì)胞數(shù)降低)(P=0.012)、手術(shù)時(shí)間≥3小時(shí)(P=0.004)、引流時(shí)間≥15天(P=0.032)及術(shù)前接受輔助化療(P=0.022)是乳腺癌患者術(shù)后發(fā)生切口感染的危險(xiǎn)因素。結(jié)論乳腺癌術(shù)后切口感染原因復(fù)雜,術(shù)中加強(qiáng)感染控制,圍術(shù)期加強(qiáng)營(yíng)養(yǎng)支持、積極控制血糖,并給予患者免疫治療及合理使用抗生素均有助于降低術(shù)后切口感染發(fā)生率。
[Abstract]:Objective to study the classification and risk factors of postoperative incision infection in breast cancer patients, and to provide reference for prevention of postoperative incision infection. Methods from October 2012 to October 2015, 1242 patients undergoing breast cancer surgery were selected as study subjects, and the secretion of 38 patients with incisional infection was cultured by bacteriology. The incidence of postoperative incision infection and related risk factors were analyzed statistically. Results the incidence of incision infection was 3.06% in breast cancer patients, and 43 strains of pathogenic bacteria were detected in the site of incision infection, of which 24 were Gram-negative bacteria (55.8%), 19 were Gram-positive bacteria (44.2%). Gram-negative bacteria were the main drug resistant bacteria. Statistics showed that age 鈮，

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