王继祯,陈永聪,刘鹏辉,苏晓燕,牟梓源,毛杰

• 1:兰州大学公共卫生学院
• 2:兰州大学第二医院(第二临床医学院)

摘要(Abstract)：

目的 探讨胃癌根治术后感染的危险因素，为优化围手术期感染预防提供依据。方法 对甘肃省某三甲医院2021—2023年1 056例胃癌根治手术患者进行回顾性研究。将患者分为感染组(105例)和非感染组(951例)；通过单因素、多因素logistic回归分析胃癌患者术后感染的潜在危险因素。结果 多因素logistic回归分析确定了术后感染的独立风险因素：较大的年龄(OR=1.028,95%CI:1.001～1.056)、体质量指数(BMI)≥28(OR=2.319,95%CI:1.044～5.152)、糖尿病(OR=2.293,95%CI:1.047～5.023)、胃癌部位(以贲门为参照，胃窦部位OR=2.391,95%CI:1.152～4.962)、术中失血量≥100 mL(OR=1.874,95%CI:1.179～2.978)、呼吸机使用天数(OR=1.163,95%CI:1.031～1.313)和中心静脉置管天数(OR=1.064,95%CI:1.031～1.097)。与开放性手术相比，腹腔镜手术是重要的保护性因素(OR=0.107,95%CI:0.053～0.215)，远端胃切除术组(DG)的术后感染风险低于全胃切除术(TG)(OR=0.438,95%CI:0.254～0.754)。结论 胃癌根治术后感染的风险是多因素的，与患者的因素(年龄、肥胖、糖尿病)，肿瘤部位，手术因素(手术种类、程度、失血)和侵入性操作等密切相关，应针对可改变的风险因素加强围术期管理，以期降低术后感染风险。

关键词(KeyWords)： 胃癌;根治性胃切除术;感染;危险因素;腹腔镜手术;预防和控制

Abstract:

Keywords:

基金项目(Foundation): 中国高校产学研创新基金资助课题（2024GR080）

作者(Author): 王继祯,陈永聪,刘鹏辉,苏晓燕,牟梓源,毛杰

DOI: 10.13515/j.cnki.hnjpm.1006-8414.2026.04.008

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