Tỷ lệ nhiễm khuẩn vết mổ trên bệnh nhân ung thư phẫu thuật đường tiêu hóa tại Bệnh viện Ung bướu Tp. Hồ Chí Minh=Prevalence of surgical site infection in cancer patients undergoing gastrointestinal surgery in Ho Chi Minh City Oncology Hospital

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Tác giả: Huy Quốc Thắng Đặng, Đình Thanh Đỗ, Thị Ngọc Diễm Đỗ, Hoa Hạnh Huỳnh, Trung Lê, Xuân Bính Lê, Thị Hồng Nhung Nguyễn, Thị Khánh Ngọc Nguyễn, Thị Vĩnh Linh Nguyễn, Đình Cường Phạm, Thị Hải Hương Phạm, Huy Hoàng Trần, Quang Hùng Võ, Thị Thùy Linh Chi Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.84-91

Bộ sưu tập: Metadata

ID: 243468

Thêm vào giỏ

Determine the rate of surgical site infection (SSI) for gastrointestinal surgery cases and related factors. Determine the spectrum of common pathogenic bacteria and antibiotics resistance characteristics in SSI patients. Method: Prospective surveillance. Using univariate statistics of patients's risk factors. Multivariable logistic regression analysis of risk factors with p-value <
0.05 from univariate results. Use chi-square test for the association of risk factors with surgical site infection rate. SSI monitoring forms were collected. Statistics are analyzed and stored by Excel, Stata13.1. Results: The overall rate of surgical site infection (SSI) in cancer patients after gastrointestinal surgery is 4.45%. Specifically, the SSI rate for exploratory laparotomy-perforation repair-peritoneal lavage-drainage is 14.29%, rectal surgery is 8.64%, gastrostomy is 4.29%, colon surgery is 3.56%, colostomy is 3.18%, gastric surgery is 1.87%, and small intestine surgery is 2.22%. Risk factors for SSI after gastrointestinal surgery include: anesthesia method (p<
0.026), preoperative chemoradiation (p<
0.020), and wound classification (p<
0.001). Surgical site infections during hospitalization are higher than after discharge (78.85% and 21.15%). The rates of superficial, deep, and organ/space SSIs are 42.3%, 25%, and 32.75% respectively. The common pathogenic bacteria group in SSIs are Gram-negative bacteria (E. coli: 48.1%
Klebsiella pneumonia: 25.9%
Enterobacter sp: 18.65%
Acinetobacter baumannii: 3.7%, and Proteus mirabilis: 3.7%). Conclusion: Research at the Oncology Hospital provides data on SSI after gastrointestinal surgery in 2023 and identifies risk factors on SSI for cancer patient. The data presented in this study are used as a premise to develop intervention packages and improve the problem of surgical site infections in subsequent studies.Xác định tỷ lệ nhiễm khuẩn vết mổ (NKVM) cho các trường hợp phẫu thuật (PT) đường tiêu hóa và các yếu tố liên quan. Xác định phổ vi khuẩn gây bệnh thường gặp và đặc điểm kháng thuốc trên đối tượng bệnh nhân NKVM. Phương pháp: Nghiên cứu tiến cứu. Thống kê đơn biến các yếu tố nguy cơ của bệnh nhân. Phân tích hồi quy logistic đa biến các yếu tố nguy cơ có giá trị p<
0,05 từ kết quả của đơn biến. Sử dụng kiểm định chi bình phương cho mối liên quan của các yếu tố nguy cơ với tỷ lệ NKVM. Thu thập dữ liệu bằng phiếu giám sát NKVM, phân tích lưu trữ, thống kê dữ liệu bằng phần mềm Excel và Stata13.1. Kết quả: Tỷ lệ NKVM chung của các bệnh nhân ung thư sau phẫu thuật đường tiêu hóa là 4,45%. Trong đó, tỷ lệ NKVM của mổ bụng thăm dò-vá lỗ thủng-rửa bụng-dẫn lưu là 14,29%, phẫu thuật trực tràng là 8,64%, mở dạ dày ra da là 4,29%, đại tràng là 3,56%, mở hậu môn nhân tạo là 3,18%, dạ dày là 1,87% và ruột non là 2,22%. Các yếu tố nguy cơ của NKVM sau phẫu thuật đường tiêu hóa bao gồm: phương pháp vô cảm (p<
0,026), hóa xạ trước phẫu thuật (p<
0,020) và phân loại vết mổ (p<
0,001). NKVM trong thời gian nằm viện cao hơn sau xuất viện (78,85% và 21,15%). Tỷ lệ NKVM nông, sâu, cơ quan lần lượt là 42,3%, 25% và 32,75%. Nhóm vi khuẩn gây bệnh thường gặp trong NKVM là vi khuẩn gram âm (E. coli: 48,1%
Klebsiella pneumonia: 25,9%
Enterobacter sp: 18,65
Acinetobacter baumannii: 3,7% và Proteus mirabilis: 3,7%). Kết luận: Nghiên cứu ở BVUB cung cấp dữ liệu về NKVM sau phẫu thuật đường tiêu hóa năm 2023 và xác định được các yếu tố nguy cơ gây NKVM cho bệnh nhân ung thư. Các số liệu được trình bày trong nghiên cứu này được sử dụng làm tiền đề xây dựng các gói can thiệp phòng ngừa NKVM.

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