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1.
Article in English | WPRIM | ID: wpr-922608

ABSTRACT

OBJECTIVES@#Perioperative neurocognitive disorders (PND) is one of the important factors affecting the recovery of the elderly after surgery, and sleep disorders are also one of the common diseases of the elderly. Previous studies have shown that the quality of postoperative sleep may be factor affecting postoperative cognitive function, but there are few studies on the relationship between preoperative sleep disorders and postoperative cognitive dysfunction. This study aims to explore the relationship between preoperative sleep disorders and postoperative delayed neurocognitive recovery in elderly patients, and provide references for improving the prognosis and quality of life of patients.@*METHODS@#This study was porformed as a prospective cohort study. Elderly patients (age≥65 years old) underwent elective non-cardiac surgery at Xiangya Hospital of Central South University from October 2019 to January 2020 were selected and interviewed 1 day before the operation. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) were used to assess the patient's baseline cognitive status. Patients with preoperative MMSE scores of less than 24 points were excluded. For patients meeting the criteria of inclusion, Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the patients, and the patients were divided into a sleep disorder group and a non-sleep disorder group according to the score. General data of patients were collected and intraoperative data were recorded, such as duration of surgery, anesthetic time, surgical site, intraoperative fluid input, intraoperative blood product input, intraoperative blood loss and drug use. On consecutive 5 days after surgery, Numerical Rating Scale (NRS) was used to evaluate the sleep of the previous night and the pain of the day, which were recorded as sleep NRS score and pain NRS score; Confusion Assessment Method for ICU (CAM-ICU) scale and Confusion Assessment Method (CAM) scale were used to assess the occurrence of delirium. On the 7th day after the operation, the MMSE and MoCA scales were used to evaluate cognitive function of patients. We compared the incidence of postoperative complications, the number of deaths, the number of unplanned ICU patients, the number of unplanned secondary operations, etc between the 2 groups. The baseline and prognosis of the 2 groups of patients were analyzed by univariate and multivariate logistics to analyze their correlation.@*RESULTS@#A total of 105 patients were collected in this study, including 32 patients in the sleep disorder group and 73 patients in the non-sleep disorder group. The general information of the 2 groups, such as age, gender, body mass index, and surgery site, were not statistically significant (all @*CONCLUSIONS@#Preoperative sleep disorders can increase the risk of delayed neurocognitive function recovery in elderly patients. Active treatment of preoperative sleep disorders may improve perioperative neurocognitive function in elderly patients.


Subject(s)
Aged , Humans , Mental Status and Dementia Tests , Postoperative Complications/epidemiology , Prospective Studies , Quality of Life , Sleep Quality , Sleep Wake Disorders/etiology
2.
Rev. cuba. pediatr ; 92(2): e875, abr.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126748

ABSTRACT

Introducción: El neonato que se interviene quirúrgicamente está expuesto al desarrollo de infecciones. El lactato sérico ha sido recomendado como criterio diagnóstico de sepsis. Objetivo: Determinar la magnitud de asociación del valor del lactato sérico con la sepsis en el neonato intervenido quirúrgicamente. Métodos: Estudio entre 2013 y 2016, en el Hospital Pediátrico Universitario William Soler, en 307 neonatos intervenidos quirúrgicamente. Las variables se agruparon en: clínicas (edad gestacional, peso al nacer, causa de la intervención quirúrgica, localización de la infección) y paraclínicas (microorganismo causal, lactato sérico). Se aplicó la prueba de correlación lineal de Pearson parcial y se estimó odds ratio con el control de la variable infección (sí y no) para identificar la correlación entre los valores de lactato sérico en el preoperatorio y en el posoperatorio. Resultados: De los neonatos 63 tenían bajo peso (20,52 por ciento) y 55 eran pretérminos (17,92 por ciento). En los neonatos infectados 20,83 por ciento fueron operados por afecciones digestivas (n= 35); las infecciones sistémicas alcanzaron 67,74 por ciento (n= 42), ocasionadas en 45,24 por ciento por Cándida sp. La velocidad de cambio de los valores del lactato sérico en los infectados (p= 0,001) significó que por cada unidad en mmol/L que ascendió el lactato preoperatorio, en el posoperatorio se incrementó 0,489 mmol/L y estos cambios fueron debidos en 16,9 por ciento a los valores del lactato preoperatorio. Conclusiones: El lactato sérico está asociado a la infección en los neonatos intervenidos quirúrgicamente y es un biomarcador de sepsis útil en los cuidados intensivos neonatales(AU)


Introduction: The newborn undergoing a surgery is exposed to the development of infections. The serum lactate has been recommended as a diagnostic criterion of sepsis. Objective: To determine the magnitude of association of the value of serum lactate with sepsis in the newborn undergoing a surgery. Methods: Study conducted from 2013 to 2016 in William Soler Pediatric Teaching Hospital, to 307 newborns whom underwent surgery. The variables were grouped in: clinical (gestational age, birth weight, cause of surgical intervention, location of the infection) and paraclinical (causative microorganisms, serum lactate). The partial Pearson's test of linear correlation was applied and it was estimated the odds ratio with the control of the variable infection (yes and no) to identify correlation between serum lactate values in the preoperative and postoperative results. Results: Of the newborns, 63 were under weight (20.52 percent) and 55 were preterm infants (17.92 percent). In the infected newborns, 20.83 percent were operated due to digestive conditions (n= 35); systemic infections reached 67.74 percent (n= 42), caused in 45.24 percent by Candida sp. The rate of change of the values of serum lactate in infected subjects (p= 0.001) meant that for each unit in mmol/L in which increased the preoperative lactate, the postoperative increased 0.489 mmol/L; and these changes were due in a 16.9 percent to the values of preoperative lactate. Conclusions: The serum lactate is associated to the infection in newborns that underwent surgery and is a useful biomarker of sepsis in neonatal intensive care(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Postoperative Complications/diagnosis , Sodium Lactate/therapeutic use , Biomarkers
3.
Medisan ; 24(3)mayo.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1125120

ABSTRACT

Introducción: La mayor expectativa de vida en la población general ha aumentado la prevalencia de las enfermedades del sistema eléctrico de conducción cardíaca y, con ello, la indicación e implante de marcapasos. Objetivo: Identificar los factores de riesgo de infección tras la implantación de marcapasos permanente. Métodos: Se realizó un estudio analítico, de casos y controles, de los 192 pacientes, a los cuales se les implantó marcapasos permanente entre enero de 2017 y diciembre de 2019 en el Servicio de Cardiología del Hospital Clinicoquirúrgico Docente Celia Sánchez Manduley de la provincia de Granma. El grupo de estudio estuvo integrado por los 38 que presentaron infección tras ese proceder y por cada paciente de este grupo se escogieron 2, que también recibieron este dispositivo y no tuvieron infección, que formaron parte de los controles. Se estudiaron variables dependientes del paciente, del dispositivo, del proceder y de los exámenes practicados. Se utilizaron el test de Fisher y la prueba de la X2 para variables cualitativas, según correspondiera y la prueba de la T de Student para las cuantitativas. Para determinar los factores de riesgo de infección se utilizó un modelo de regresión logística. Resultados: Prevaleció el sexo masculino (60,5 %) y la media de edad fue de 76,1 años. Como factores de riesgo predominaron el uso de antiagregantes y anticoagulantes, el antecedente de diabetes mellitus y las cifras de glucemia mayores de 8,0 mmol/L. Conclusiones: Existen factores de riesgo de infección modificables, por lo que constituye un gran reto médico actuar sobre estos para prevenir complicaciones letales para la vida.


Introduction: The higher life expectancy in the general population has increased the prevalence of diseases of the heart conduction of electric system and, with it, the indication and implant of pacemaker. Objective: To identify the risk factors of infection after the permanent pacemaker implantation Methods: A cases and controls analytic study of 192 patients, to whom a permanent pacemaker was implanted between January, 2017 and December, 2019 was carried out in the Cardiology Service of Celia Sánchez Manduley Teaching Clinical Surgical Hospital from Granma. The study group was integrated by the 38 patients that presented infection after that procedure and every each patient of this group 2 were chosen that also received this device and had no infection that were part of the control group. The variables dependent on the patient, the device, the procedure and the exams were studied. The Fisher test and the chi-square test were used for qualitative variables, as corresponded and the Student t test for the quantitative variables. To determine the risk factors of infection a model of logistical regression was used. Results: The male sex prevailed (60.5 %) and the mean age was of 76.1 years. As risk factors the use of antiagregants and anticoagulants, history of diabetes mellitus and glucemia figures higher than 8.0 mmol/L prevailed. Conclusions: There are modifiable risk factors of infection, what constitutes a great challenge in medicine to influence on these factors to prevent lethal complications for life.


Subject(s)
Pacemaker, Artificial , Catheter-Related Infections , Surgical Wound Infection , Risk Factors
4.
Rev. Fac. Med. Hum ; 20(1): 162-163, Jan-Mar. 2020.
Article in English, Spanish | LILACS-Express | LILACS | ID: biblio-1049027

ABSTRACT

En este trabajo se ha realizado una búsqueda exhaustiva de estudios que evidencien el efecto de la Hemoglobina glicosilada (HbA1c) en el desarrollo de infección post quirúrgica en paciente con pie diabético. En nuestro país la prevalencia de pacientes con diabetes mellitus alcanza hasta un 8.4%, al respecto se sabe que una de las mayores complicaciones de esta enfermedad es el desarrollo de pie diabético y que consecuentemente a esta patología hasta un 20% de estos pacientes termina en una amputación, se sabe también que los pacientes con diabetes mellitus tienen un alto riesgo de complicaciones postoperatorias, incluyendo infecciones, curación inadecuada de heridas, eventos cardiovasculares, trombo embolismo venoso, y la mortalidad. Debido a que se ha pensado que la hiperglucemia media este riesgo, sean realizado diferentes estudio internacionales que buscan comprobar y dar a conocer esta asociación, sin embargos, debido a que no se han encontrado estudios nacionales al respecto, no se puede hacer conclusiones sólidas para nuestra población, por lo cual este manuscrito pretende motivar a la realización de los mismos que reflejen la problemática nacional


In this work an exhaustive search has been made of studies that show the effect of glycosylated hemoglobin (HbA1c) in the development of post surgical infection in diabetic foot patients. In our country the prevalence of patients with diabetes mellitus reaches up to 8.4%, in this regard it is known that one of the biggest complications of this disease is the development of diabetic foot and that consequently to this pathology up to 20% of these patients end in An amputation, it is also known that patients with diabetes mellitus have a high risk of postoperative complications, including infections, inadequate wound healing, cardiovascular events, venous embolism thrombus, and mortality. Because it has been thought that hyperglycemia mediates this risk, different international studies are carried out that seek to verify and publicize this association, however, because no national studies have been found in this regard, no solid conclusions can be drawn for our population, for which this manuscript aims to motivate the realization of them that reflect the national problem

5.
Article in Chinese | WPRIM | ID: wpr-847425

ABSTRACT

BACKGROUND: The risk factors of surgical site infection after spinal surgery are diverse and complex. At present, there is still a great controversy on the study of the risk factors of postoperative infection of spine. OBJECTIVE: To systematically evaluate the independent risk factors of surgical site infection after spinal surgery, and to provide theoretical basis for the prevention and treatment of surgical site infection. METHODS: Between January 2004 and June 2019, the Chinese and foreign databases were retrieved. According to the inclusion and exclusion criteria, we collected case-control and cohort studies on independent risk factors for surgical site infection after surgery. After extraction of available data, independent risk factors (hypertension, diabetes, obesity, smoking, history of surgery) for the merger OR value and 95%CI were calculated by using the fixed effect model and random effect model for meta-analysis. The consistency of the results was compared. The reliability of the merge result was analyzed. RESULTS AND CONCLUSION: (1) A total of 19 articles were included, with 1 008 cases of surgical site infection, and the control group contained 7 527 cases. (2) The independent risk factors for merger OR value (95%CI) from high to low in turn were diabetes (OR=3.24, 95%CI: 2.09-5.02), obesity (OR=2.99, 95%CI: 1.77-5.05), surgical history (OR=2.12, 95%CI: 1.79-2.50), hypertension (OR=1.90, 95%CI: 1.34-2.69), and smoking (OR=1.85, 95%CI: 1.39-2.48). (3) Results indicated that diabetes, hypertension, obesity, smoking and surgical history are all independent risk factors for the occurrence of surgical site infection after spinal surgery, and each independent risk factor is positively correlated with the occurrence of surgical site infection after spinal surgery.

6.
Rev. mex. anestesiol ; 42(2): 104-110, abr.-jun. 2019. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1094158

ABSTRACT

Resumen: Las suspensiones comerciales de propofol, por su composición farmacéutica, soportan el crecimiento de diversos microorganismos; la aplicación de propofol, contaminado microbianamente luego de ser retirado de su envase original, ha sido vinculada a brotes de infección postoperatoria. La adición de sales de ácido etilendiaminotetraacético (EDTA) retarda el crecimiento de estos microorganismos. Aquí se comparó el crecimiento, a lo largo de 48 horas y en tres temperaturas (ambiente, 35 y 42 oC), de siete cepas bacterianas y tres de levaduras, en cuatro formulaciones de propofol disponibles en México, una de ellas adicionada con EDTA. Consistentemente, el crecimiento fue menor en la suspensión con EDTA, comparada con las tres que no lo contienen, con variaciones entre microorganismos y temperaturas: desde muerte inicial de parte del inóculo, o inhibición completa y sostenida del crecimiento, hasta inhibición parcial. Aunque la adición de EDTA no debe considerarse como un sustituto del manejo aséptico del propofol, que debe extenderse durante el período perioperatorio, ciertamente disminuye la proliferación microbiana que puede darse por contaminación accidental, disminuyendo asimismo el riesgo de infección para el paciente.


Abstract: Commercially available propofol suspensions, due to their pharmaceutical composition, support the growth of several microorganisms; the administration of propofol suspensions that became microbially-contaminated after being removed from their original vial, has been linked to postsurgical infections. Addition of ethylenediaminetetracetic acid (EDTA) salts delays the growth of such microorganisms. Here, we compared the growth of seven bacterial strains and three yeast strains, along 48 hours and at three different incubation temperatures (room temperature, 35 and 42 oC), in four propofol formulations available in Mexico, one of them with supplemented EDTA. Consistently, microbial growth was diminished in the formulation supplemented with EDTA, compared to the other three, although with variations between microorganisms and incubation temperatures: from initial reduction in viable organisms, to complete and sustained growth inhibition, to only partial growth inhibition. While the addition of EDTA to propofol suspensions must not be considered as a substitute for aseptic handling of the drug, it certainly diminishes microbial growth that can occur after accidental contamination, reducing the infection risk for the patient.

7.
Organ Transplantation ; (6): 182-2019.
Article in Chinese | WPRIM | ID: wpr-780512

ABSTRACT

Objective To evaluate the clinical efficacy and safety of ABO incompatible living kidney transplantation(ABOi-KT). Methods Clinical data of 11 donors and recipients with ABOi-KT were retrospectively analyzed. All the recipients were treated with desensitization before operation. The recovery condition of renal function and blood type antibody titer of the ABOi-KT recipients were monitored after operation. The incidence of complications and clinical prognosis of ABOi-KT recipients were observed. Results The serum creatinine (Scr) of 11 recipients were well recovered after ABOi-KT. No delay in recovery of graft renal function. Among them, 2 recipients experienced a significant increase in the Scr level at postoperative 14 and 45 d respectively, 1 recipient showed criticality cellular rejection after operation and 1 recipient presented with elevated Scr level at postoperative 33 d, accompanied by an increase in blood type antibody titer. The condition became stable after corresponding treatment. The remaining 7 recipients obtained normal graft renal function and postoperative blood type antibody titer did not rebound. During postoperative follow-up until November 2018, no recipient died or graft renal failure occurred. The survival rate of the recipient and graft renal was 100%. Among them, 3 patients suffered from postoperative complications, including pulmonary infection, BK viruria and granulocytopenia, which were cured after symptomatic treatment. Conclusions ABOi-KT is safe, feasible and yields high long-term clinical efficacy, which can increase the source of living donor kidney and relieve the shortage of donor kidney.

8.
Clinical Medicine of China ; (12): 150-155, 2019.
Article in Chinese | WPRIM | ID: wpr-744971

ABSTRACT

Objective We performed a retrospective study to determine the epidemiological characteristics of Klebsiella pneumoniae infection after neurosurgery and to elucidate the risk.Methods Patients who underwent neurosurgery between January 2012 and December 2016 were included.Demographic,clinical,laboratory,and microbiological data were systemically recorded.17 clinical trials and 7 clinical laboratory indicators were evaluated as risk factors for meningitis.Results Forty-five cases of neurosurgery patients led to K.pneumoniae infection were analyzed,K.pneumoniae ESBLs production ratio is 37.8% (17/45),the sensitivity rate of carbapenem antibiotics was more than 80.0% (36/45).The patients were mainly in the north of China with an average age of 36.3±18.3 years old and a male ratio of 53.3% (24/45).The highest proportion of patients are pituitary adenoma and glioblastoma and the mortality rate was 22.2% (10/45).The mean length of hospital stay was 29.2± 13.7 days,and the most likely to develop K.pneumoniae were 7.8±6.9 days after neurosurgery.The ICU occupancy rate was 51.1% (23/45).Chi-square test showed that older age (>50 years old) and sepsis were risk factors for death from K.pneumoniae infection after neurosurgery.Multivariate logistic analysis showed that the risk of infection was associated with the incidence of sepsis (OR 16.199,P =0.010).There were no statistically significant differences between the survival and death patients by seven laboratory tests (P>0.05).Conclusion The infection of neurosurgery caused by K.pneumoniae has a high mortality rate.Among them,concurrent sepsis is the lethal risk factor of infection.Clinically,identification of the risk factors as soon as possible will help physicians to improve patient care and improve the surgical success.

9.
Cancer Research and Clinic ; (6): 437-441, 2019.
Article in Chinese | WPRIM | ID: wpr-756773

ABSTRACT

Objective To detect the changes of cellular immune level in patients with different grades of glioma in perioperative period, and to investigate its relationship with the postoperative intracranial infection. Methods A total of 53 patients with glioma newly diagnosed by pathology who underwent the surgical treatment in the First Hospital of Shanxi Medical University from September 2017 to September 2018 were collected. According to the World Health Organization (WHO) classification criteria, the patients were divided into the low-grade group (grade Ⅰ-Ⅱ, 21 cases) and the high-grade group (grade Ⅲ-Ⅳ, 32 cases). The peripheral blood at the time of 1 day before the operation, 1 day and 7 days after the operation was drawn to detect the T lymphocyte subsets, and then the differences of cell immunity indexes from different grade gliomas were analyzed. The relationship between immune level and postoperative intracranial infection was analyzed. SPSS 22.0 statistical software was used to analyze the data. Results The levels of CD3+, CD4+, CD8+, CD4+CD25+Foxp3+and CD4+/CD8+in the high-grade group at the time of 1 day before the operation were (54.09±4.25)%, (31.93±3.08)%, (34.23±2.48)%, (9.66±1.47)%, 0.93±0.06, respectively; the levels at the time of 1 day after the operation were (48.84±3.69)%, (27.49±2.41)%, (34.99±2.96)%, (11.09±1.70)%, 0.84± 0.05, respectively; the levels at the time of 7 days after the operation were (59.45 ±3.47)%, (33.59 ±2.66)%, (31.99±1.97)%, (7.45±1.48)%, 1.05±0.07, respectively. The levels of CD3+, CD4+, CD8+, CD4+CD25+Foxp3+and CD4+/CD8+in the low-grade group at the time of 1 day before the operation were (62.37±6.57)%, (34.88± 4.43)%, (30.16 ±3.75)%, (6.30 ±1.29)%, 1.16 ±0.11, respectively; the levels at the time of 1 day after the operation were (55.44 ±7.25)%, (29.05 ±4.04)%, (31.66 ±3.13)%, (7.95 ±1.67)%, 0.92 ±0.11, respectively; the levels at the time of 7 days after the operation were (67.73 ±7.18)%, (35.55 ±4.95)%, (28.10 ±3.12)%, (5.50 ± 1.25)%, 1.27±0.12, respectively. The levels of CD3+, CD4+, CD4+/CD8+before and after the operation in the high-grade group were lower than those in the low-grade group (all P< 0.05), while the levels of CD8+and CD4+CD25+Foxp3+were higher than those in the low-grade group (all P<0.05). Compared with the levels at the time of 1 day before the operation, the levels of CD3+, CD4+, CD4+/CD8+at the time of 1 day after the operation of both groups were decreased, while the levels of CD8+and CD4+CD25+Foxp3+were increased (all P< 0.05). The levels of CD3+, CD4+and CD4+/CD8+ at the time of 7 days after the operation in the both groups were increased, while the levels of CD8+ and CD4+ CD25+ Foxp3+ were decreased (all P< 0.05). Among 53 patients, 8 cases had postoperative intracranial infection, and the infection rate was 15.09%. Age, duration of surgery, pathological stage, and intraoperative blood transfusion were the independent affecting factors of postoperative intracranial infection of cerebral glioma (OR= 1.513, P= 0.024; OR= 1.722, P<0.01; OR= 1.365, P= 0.001; OR= 1.262, P< 0.01). Conclusions The peripheral blood cellular immune level of glioma patients is related with the malignancy of glioma. The inhibition degree of the cellular immunity could be relieved after the resection of glioma. The detection of T lymphocyte subsets could be considered as an evaluating index for the malignancy and prognosis in patients with glioma. The clinical detection of cellular immune can play a positive role in predicting and preventing the postoperative intracranial infection in patients with glioma.

10.
Article in Chinese | WPRIM | ID: wpr-711533

ABSTRACT

Objective To analyze the prevention value of endoscopic retrograde appendicitis treatment (ERAT) for postoperative infection of patients with appendicitis. Methods A total of 71 patients with acute appendicitis were selected and divided into two groups, 35 patients in the observation group were treated with ERAT, and 36 patients of the control group underwent laparoscopic appendectomy.The operation indicators, postoperative adverse events, pain scores, and levels of serum inflammatory factors were compared between the two groups. Results The observation group got a longer operation time, less bleeding, shorter in-bed and hospital stay, and lower hospital cost ( all P<0. 05). The main postoperative adverse event was recurrence in the observation group and infection in the control group, and the total adverse event rate was no significantly different between the two groups ( P>0. 05). Twelve hours after treatment, the pain score of the observation group was lower than that of the control group ( P<0. 05). The post-operational serum levers of hypersensitivity C reactive protein, interleukin 1β, interleukin 6, and tumor necrosis factor α decreased in both groups, while the serum levers of interleukin 4 and interleukin 10 increased, especially in the observation group ( all P<0. 05). Conclusion ERAT is more conducive to balance serum inflammatory factors and stabilize immune function compared with laparoscopic appendectomy, which can effectively prevent postoperative infection.

11.
Article in Chinese | WPRIM | ID: wpr-699480

ABSTRACT

Objective To analyze the risk factors for postoperative infection of patients with colorectal cancer,and to investigate the distribution of pathogenic bacteria and drug resistance.Methods A total of 300 patients with colorectal cancer who underwent operation were selected from June 2013 to June 2017 in the Central Hospital of Tongchuan Mining Bureau,and the patients were divided into the infection group and the non-infection group according to the postoperative infection.The clinical data were compared between the two groups,and the risk factors for postoperative infection in colorectal cancer patients were analyzed by logistic regression.The total automatic bacterial culture apparatus was used for bacterial culture,and the drug sensitivity test was carried out by Kirby-Bauer.Results Among the 300 colorectal cancer patients,there were 61 cases of incision infection (infection group) and 239 cases without incision infection (non-infection group) after operation,the postoperative infection rate was 20.33% (61/300).There were significant differences in the operation method,red blood cell counts,the levels of albumin,prealbumin and hemoglobin between the two groups (P < 0.05);but there was no significant difference in sex,age,body mass index,diabetes mellitus history,abdominal surgery history,smoking history,drinking history,operation time,intraoperative bleeding volume,hospitalization time,indwelling time of urethral catheter,white blood cells and C-reactive protein levels between the two groups(P > 0.05).Multiple factor logistic regression analysis showed that the decrease of albumin and prealbumin level was the independent risk factor for postoperative infection in patients with colorectal cancer (P <0.05).A total of 52 strains of pathogenic bacteria were detected in 61 cases of colorectal cancer combined with postoperative infection,including 38 strains of gram negative bacteria (73.08%),10 strains of gram positive bacteria (19.23%) and 4 strains of fungi (7.69%).Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa had high drug resistance to ampicillin,cefaclor,ceftriaxone,ceftizoxime,cefepime,cefoperazone,ceftazidime and ofloxacin;but they had low drug resistance to piperacillin,imipenem and amikacin.Conclusion The incidence of postoperative infection in patients with colorectal cancer is higher,the decrease of albumin and prealbumin is the independent risk factor for postoperative infection in patients with colorectal cancer.Gram-negative bacteria are the main pathogens of postoperative infection in patients with colorectal cancer and have high resistance to common antibiotics.

12.
Article in Chinese | WPRIM | ID: wpr-694221

ABSTRACT

Objective To investigate the incidence and influencing factors of postoperative infection in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods A retrospective study was conducted on the HCC patients who received TACE during the period from January 2016 to December 2016. The possible risk factors that might induce postoperative infection after TACE were evaluated by using univariate analysis and multivariate logistic regression analysis. The risk factors were further stratified into very high risk factors, high risk factors, moderate risk factors and low risk factors. Results Among 386 HCC patients who showed effective response to TACE, postoperative infection occurred in 17 patients, the incidence rate was 4.4%. Ascites, history of hepatobiliary resection surgery or preoperative liver cancer rupture with bleeding, history of liver abscess or previous postoperative infection after TACE were the very high risk factors of infection after TACE. Preoperative serum total protein value <60 g/L was a high risk factor. The presence of tumor thrombus in portal vein or in vena cava was a moderate risk factor. Conclusion Ascites, previous hepatobiliary surgery, preoperative liver cancer rupture with bleeding, history of liver abscess and history of infection after TACE are significantly correlated with the occurrence of infection after TACE.

13.
Article in Chinese | WPRIM | ID: wpr-692772

ABSTRACT

Objective To investigate the distribution and drug resistance of pathogens in elderly patients with gastric cancer complicated with diabetes mellitus.Methods 367 elderly patients with gastric cancer and diabetes mellitus were selected from the hospital from March 2010 to March 2017.The samples were isolated and cultured.The Gram positive bacteria were tested by GN201,the Gram negative bacteria susceptibility test was carried out by GP,and the drug susceptibility test was carried out by disk diffusion method.Results There were 68 cases of postoperative infection in gastric cancer patients with diabetes mellitus,and 79 strains were isolated and cultured.Among the gram negative bacteria,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens.Among the Gram positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens.The main Gram negative bacteria,Escherichia coli to ceftazidime with levofloxacin resistance rates were 93.33% and 80.00%;Klebsiella pneumoniae had a higher drug resistance rate for cefoperazone and ciprofloxacin,76.92% and 69.23% respectively;a relatively high rate of Pseudomonas aeruginosa resistant to levofloxacin was 80.00%.Among the gram positive bacteria,the re-sistance rates of Staphylococcus aureus to penicillin and erythromycin were relatively high,respectively 91. 67% and 83.33%.Staphylococcus epidermidis had relatively high resistance rates to penicillin and erythromy-cin,100.00% and 77.78% respectively.Conclusion Gastric cancer complicated by diabetes mellitus elderly patients with postoperative infection of pathogenic bacteria distribution is given priority to with Gram-negative bacteria was the most common in,Pseudomonas aeruginosa,the main pathogenic bacteria of Escherichia coli to ceftazidime with levofloxacin resistant rate of Klebsiella pneumoniae was higher on cefoperazone and ciproflox-acin resistant Pseudomonas aeruginosa,the resistance rate of Pseudomonas aeruginosa to levofloxacin is high, and it is important to apply antibiotics rationally according to drug sensitivity test.

14.
Chinese Journal of Epidemiology ; (12): 988-992, 2018.
Article in Chinese | WPRIM | ID: wpr-738084

ABSTRACT

Objective To investigate the influence of postoperative infection on average hospitalization days and medical costs in patients with nervous system tumor.Methods The tumor patients treated in neurosurgery ward from July 1,2015 to June 30,2017 were included in the study.The patients with and without postoperative infections were divided into a case group and a control group,respectively (1:1 ratio),matched by admission time (± 3 months),age (± 5 years) and surgical site.Average hospitalization days and medical costs between the two groups were analyzed.Results The incidence of postoperative infection was 5.66%,the surgical site infection and lower respiratory tract infection accounted for 54.72% and 31.32% of the total,respectively.The median of hospitalization days in the case group was 20.5,8.5 days longer than that in the control group (Z=-10.618,P<0.001).The median of total medical costs in the case group was 91 573.42 yuan,higher than that of the control group by 30 518.17 yuan (Z=-9.988,P<0.001).The average costs of surgical and lower respiratory tract infection were 84 888.50 yuan and 110 442.64 yuan,respectively.Among them,surgical site infection or lower respiratory tract infection caused the extra cost of 23 627.49 yuan (Z=-6.627,P<0.001) and 43 631.36 yuan (Z=-4.954,P<0.001),respectively.Conclusions Postoperative infection greatly increased the patient's financial burden,prolonged the hospitalization duration and resulted in unnecessary use of health resources.It is necessary to pay close attention to postoperative infection.

15.
Chinese Journal of Epidemiology ; (12): 988-992, 2018.
Article in Chinese | WPRIM | ID: wpr-736616

ABSTRACT

Objective To investigate the influence of postoperative infection on average hospitalization days and medical costs in patients with nervous system tumor.Methods The tumor patients treated in neurosurgery ward from July 1,2015 to June 30,2017 were included in the study.The patients with and without postoperative infections were divided into a case group and a control group,respectively (1:1 ratio),matched by admission time (± 3 months),age (± 5 years) and surgical site.Average hospitalization days and medical costs between the two groups were analyzed.Results The incidence of postoperative infection was 5.66%,the surgical site infection and lower respiratory tract infection accounted for 54.72% and 31.32% of the total,respectively.The median of hospitalization days in the case group was 20.5,8.5 days longer than that in the control group (Z=-10.618,P<0.001).The median of total medical costs in the case group was 91 573.42 yuan,higher than that of the control group by 30 518.17 yuan (Z=-9.988,P<0.001).The average costs of surgical and lower respiratory tract infection were 84 888.50 yuan and 110 442.64 yuan,respectively.Among them,surgical site infection or lower respiratory tract infection caused the extra cost of 23 627.49 yuan (Z=-6.627,P<0.001) and 43 631.36 yuan (Z=-4.954,P<0.001),respectively.Conclusions Postoperative infection greatly increased the patient's financial burden,prolonged the hospitalization duration and resulted in unnecessary use of health resources.It is necessary to pay close attention to postoperative infection.

16.
Rev. cuba. cir ; 56(2): 46-58, abr.-jun. 2017.
Article in Spanish | LILACS | ID: biblio-900973

ABSTRACT

La tasa de complicaciones infecciosas posoperatorias se eleva en el paciente quirúrgico, entre otras razones, debido a que resulta insuficiente el conocimiento sobre la génesis de los factores que las provocan. Esto incrementa significativamente su persistencia y las consecuencias negativas que inciden sobre el enfermo, la institución sanitaria y el sistema de salud. De ahí, la necesidad de profundizar en los diferentes aspectos cognoscitivos sobre el tema. Esta revisión actualizada pretende esclarecer los aspectos fundamentales concernientes a su génesis, diagnóstico y tratamiento preventivo y curativo con vistas a disminuir la morbilidad y mortalidad por esta lamentable complicación posquirúrgica(AU)


The rate of postoperative infective complications increases in the surgical patient due, among other reasons, to poor knowledge on the genesis of causative factors. This significantly raises their level of persistence and the negative consequences for the patient, the health institution and the health system; hence the need of delving into the different cognitive aspects of this topic. This updated review was intended to clarify the fundamental aspects of their genesis, diagnosis and preventive and curative treatment with a view to reducing morbidity and mortality from this terrible post surgical complication(AU)


Subject(s)
Humans , Infections/drug therapy , Patient Care , Postoperative Complications , Risk Factors , Review Literature as Topic
17.
Article in Chinese | WPRIM | ID: wpr-615722

ABSTRACT

Objective To analyze the therapeutic effect of povidone iodine diluent conjunctival sac combined with levofloxacin eye drops on cataract surgery to provide a basis for clinical treatment. Methods 400 patients with cataract surgery were enrolled in our hospital from January 2017 to June 2017. They were divided into two groups according to the random number table (n=200, 312 eyes) and the combined treatment group (n= 200, 325 eyes). In the conventional treatment group, levofloxacin was used to prevent postoperative infection. The combined treatment group was treated with povidone iodine dilution on the basis of conventional treatment group to prevent postoperative infection , Compared with the two groups of patients before surgery, postoperative, 2d postoperative bacterial culture and adverse reactions occurred. Results The positive rate of bacterial culture was 0.62% on the 2nd day in the combined treatment group and 5.77% in the conventional treatment group (P<0.05). The incidence of adverse reaction was 0.92% in the combined treatment group and the conventional treatment group The incidence of reaction was 2.88% (P<0.05). Conclusion The effect of povidone iodine diluent conjunctival sac rinse combined with levofloxacin eye drops on the prevention of cataract surgery is very good, which can greatly reduce the positive rate of bacterial culture and reduce the incidence of adverse reactions in patients.

18.
Article in Chinese | WPRIM | ID: wpr-611298

ABSTRACT

Objective The infection rate and the corresponding intervention measures of postoperative application of ampicillin sodium to reduce abdominal incision after operation. Methods The control group in the conventional antibiotic administration based on preoperative, postoperative combined with ampicillin sodium; research group in the control group based on the use of the corresponding operation room intervention measures. Results The incidence of incision infection in study group (18.18%) was significantly lower than the control group (4.55%)(P<0.05); the control group SDS, SAS scores did not change significantly than before , SDS of the study group, SAS scale score was significantly lower than before (P<0.05). Conclusion Application of ampicillin sodium combined with the corresponding intervention measures can significantly reduce abdominal incision surgery in two postoperative infection rate and is conducive to protect the quality of life of patients, life safety.

19.
International Eye Science ; (12): 1969-1972, 2017.
Article in Chinese | WPRIM | ID: wpr-640578

ABSTRACT

AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement. ·METHODS:The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed. ·RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6. 3% in 10 patients ( 18 eyes) . There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant (P<0. 05), which related to the infection after pocket scleral reinforcement. ·CONCLUSION:The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.

20.
Clinical Medicine of China ; (12): 142-144, 2017.
Article in Chinese | WPRIM | ID: wpr-512018

ABSTRACT

Objective To investigate the short segment(less than 2 segments)of lumbar posterior open surgery in the application of iodophor rinse operation field for the prevention of wound infection effect.Methods One hundred and sixty-four cases patients who underwent all lumbar posterior short segment(less than 2 segments)decompression and fusion in Shunyi District Hospital of Beijing from January 2012 to December 2015 were selected as study objects,and were randomly divided into two groups according to random number table method,including 87 cases of single application of physiological saline(saline group)and 77 cases with diluted iodophor rinse liquid during the operation(diluted iodophor group).The incidence of infection in patients with different irrigation patterns during 3 months after the operation was followed up,and the results were analyzed by Fisher exact probability method.Results The infection rate of saline group was 8.05%(7/87),1.30%(1/77)of iodophor group,there was significant difference between two groups(P=0.04).Conclusion The application of iodophor rinse operation field for the prevention of wound infection has obvious effect on lumbar posterior open surgery.

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