摘要
目的探讨直肠癌术后切口感染危险因素,并分析外周血细胞核因子-κB(NF-κB)蛋白水平。方法收集2016年8月-2018年9月在南阳市中心医院行直肠癌根治术后切口感染的56例直肠癌患者(感染组)的一般临床资料和病原菌情况,另选取同期行直肠癌根治术后切口未感染患者87例进行对照(未感染组),对比两组一般临床资料,分析影响患者术后切口感染的独立危险因素,并探讨NF-κB蛋白与危险因素相关性。结果56例感染者检测出85株病原菌,其中革兰阳性菌26株,占比30.59%,主要病原菌有表皮葡萄球菌、金黄色葡萄球菌;革兰阴性菌58株,占比68.24%,主要病原菌为铜绿假单胞菌、大肠埃希菌;真菌1株,占比1.18%。Logistic回归分析发现,年龄、合并糖尿病、临床分期、手术时间是影响直肠癌术后切口感染独立危险因素(OR=3.550、3.873、5.078、4.216,95%CI=1.213~10.392、1.202~12.480、1.207~21.363、1.258~14.130),差异均有统计学意义(P均<0.05);感染组NF-κB蛋白水平显著高于未感染组,差异有统计学意义(t=15.857,P<0.05);经相关性分析发现,NF-κB蛋白水平与合并糖尿病、临床分期均成显著正相关(r=0.438、0.422,P均<0.05)。结论革兰阴性菌为直肠癌术后切口感染主要致病菌,年龄、合并糖尿病、临床分期、手术时间是影响直肠癌术后切口感染独立危险因素,且NF-κB蛋白与合并糖尿病、临床分期成正相关,推测NF-κB蛋白水平监测可为直肠癌术后感染预防提供有效依据。
Objective To investigate the risk factors of incision infection after rectal cancer surgery,and analyze peripheral blood nuclear factor-kappa B(NF-κB)protein level.Methods The general clinical data of 56 rectal cancer patients who developed incision infection after undergoing radical resection of rectal cancer in the Nanyang Central Hospital between August 2016 and September 2018 were retrospectively analyzed,and pathogenic bacteria was analyzed.87 rectal cancer patients without incision infection after radical resection of rectal cancer were selected as the uninfected group.General clinical data of the two groups were compared to analyze the independent risk factors for postoperative incision infection.The correlation between NF-κB protein and risk factors was discussed.Results A total of 85 pathogenic bacteria strains were detected.Among them,there were 26(30.59%)strains of Gram-positive bacteria which mainly included Staphylococcus epidermidis and Staphylococcus aureus,58(68.24%)strains of Gram-negative bacteria which mainly included Pseudomonas aeruginosa and Escherichia coli,and 1(1.18%)strain of fungus.Logistic regression analysis found that age,diabetes,clinical stage,and operation time were independent risk factor affecting incision infection after rectal cancer surgery(OR=3.550,3.873,5.078,4.216,95%CI=1.213-10.392,1.202-12.480,1.207-21.363,1.258-14.130);the differences were statistically significant(all P<0.05).The level of NF-κB protein in the infected group was significantly higher than that in the uninfected group(t=15.857,P<0.05).Correlation analysis found that the level of NF-κB protein was significantly positively correlated with diabetes and clinical stage(r=0.438,0.422,P<0.05).Conclusions Gram-negative bacteria was the main pathogenic bacteria of incision infection after rectal cancer surgery.Age,diabetes,clinical stage,and operation time were independent risk factor affecting incision infection after rectal cancer surgery.NF-κB protein was positively correlated with diabetes and clinical stage.Monitoring the level of NF-κB protein might provide an effective basis for infection prevention after rectal cancer surgery.
作者
孟犁南
冯明明
钱国武
MENG Linan;FENG Mingming;QIAN Guowu(Department of Special Needs Ward,Nanyang Central Hospital,Nanyang,Henan 473009,China;Department of Biliary Duct General Surgery,Nanyang Central Hospital,Nanyang,Henan 473009,China;Department of Gastrointestinal Ward,Nanyang Central Hospital,Nanyang,Henan 473009,China)
出处
《热带医学杂志》
CAS
2023年第5期704-708,共5页
Journal of Tropical Medicine
基金
河南省科技发展计划项目(182102311210)
关键词
直肠癌
切口感染
NF-ΚB蛋白
革兰阴性菌
Rectal cancer
Incision infection
NF-κB protein
Gram-negative bacteria
