食管穿孔术后SSI危险因素分析

绿茵场

Risk factors for surgical site infection after surgery for esophageal perforation
R. Breigeiron 1, H. P. de Souza 2, J. P. P. Sidou 3
1General Surgery Service and Digestive Surgery, Hospital São Lucas – Pontifícia Universidade Católica do Rio Grande do Sul, and General and Trauma Surgery, Pronto Socorro de Porto Alegre, 2Surgical Department, School of Medicine – Pontifícia Universidade Católica do Rio Grande do Sul, and General and Trauma Surgery, Pronto Socorro de Porto Alegre, and 3Academic of School of Medicine – Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
SUMMARY. Esophageal perforations carry a high potential for morbidity and mortality. The prognosis depends on rapid and precise diagnosis and management. Surgical site infections (SSIs) are very common following the surgical treatment of esophageal lesions. We aimed identify significant risk factors for SSI after surgery for esophageal perforation via an historical cohort study including patients who underwent surgical management of esophageal perforation. The predictive variables were analyzed by bivariate analysis and multiple logistic regression. Eighty-one patients were studied during a 10-year period ending in 2004. The mean age was 42.6 years. In 44% of the patients the time interval between the perforation and surgery was up to 6 h and in 30% it was > 24 h. Associated lesions occurred in other cavities; 17% in the chest, 5% in the abdomen, 5% in the extremities, 4% in the spinal column and bone marrow and 2% in the face. There were grade I lesions in eight cases (10%), grade II in 64 cases (79%) and grade III in nine cases (11%). The mean time of surgery procedure was 117.2 min. The mean SSI was 7.99. SSIs occurred in 33 patients (41%). The risk factors for SSI following surgical management of esophageal perforation were: age ≥ 50 years, time delay to treatment > 24 h, associated lesion in another cavity and Injury Severity Score ≥ 15.

.....结论：食管穿孔术后SSI感染危险因素为：50岁以上病人；发病24h才予以治疗；其他腔隙存在损伤且创伤严重度评分≥15分。
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