科研之友
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摘要
Background: Surgical site infection (SSI) is a potentially morbidity and costly complication following colorectal operations. It is difficult to detect the wound infection through the patient's symptoms and signs in the early stage of incisional surgical site infections. However, there are few studies about the Early identification and diagnosis of patients with incisional SSI. The aim of this study was to assess the application of postoperational CT in the early diagnosis of incisional surgical site infections in elective colorectal surgery. Methods: Using our SSI surveillance database, we analyzed retrospectively 342 patients who underwent colorectal surgery between 2012 and 2016. There were two groups. The study group included 171 patients who had the incisional surgical site infections. The control group also included 171 patients who had the same location of the tumor (Right hemicolon, Left hemicolon and Rectum) and the thickness of subcutaneous fat was similar (The difference is less than 0.5 cm). Recorded clinical parameters included the average CT Attenuation Value (CAV for short) of the area where CAV changed obviously. The transverse diameter of the area where CAV changed obviously, C-reactive protein (CRP) levels, incisional pain and tenderness, localized swelling and redness, the treatment of the incisional surgical site infections. Then statistical analysis was carried out to get the difference of two group. Results: In the superficial incisional SSI group, the average CAV of the incision in the infected group was -0.21 +/- 19.60, and -51.00 +/- 27.35 in the normal group. T was 15.32, and P was 0.000 (P < 0.05). In the deep incisional SSI group, the average CAV of the incision of the infected group was 19.72 +/- 8.40, and 39.97 +/- 5.74 in the normal group. T was -16.415, and P was 0.000 (P < 0.05). The transverse diameter of the area where CAV changed obviously was divided into 4 group, D < 0.5 cm, 1.0 cm > D >= 0.5 cm, 2.0 cm > D >= 1.0 cm and D > 2.0 cm. There were 13 (7.6%), 21 (12.3%), 53 (31.0%) and 84 (49.1%) respectively in the infected group, and 126 (73.7%), 26 (15.2%), 13 (7.6%) and 6 (3.5%) respectively. The x(2) was 184.238, P was 0.000 (P < 0.05). There were 46 cases whoes CT scan showed obvious low density or liquid dark area (Figure 9), and we used the 5 ml or 10 ml syringe to puncture the low density or liquid dark area under the CT image guiding. 38 cases could be punctured pus, then we opened the incision for further treatment. Conclusions: Testing the incision CAV and the transverse diameter of the area where CAV changed obviously is an effective diagnostic method for the early incisional SSI. CT combining with puncture Contribute to early diagnosis and treatment for the incisional SSI, reduce the pain of patients and medical expenses.
- 出版日期2017
- 单位福建医科大学
