| ObjectivesTo investigate and analyze the current situation of nosocomial infection in patients undergoing gastric cancer surgery,to explore the risk factors of nosocomial infection in order to provide scientific basis for the formulation of measures to prevent and control nosocomial infection in patients undergoing gastric cancer surgery,so as to reduce the occurrence of nosocomial infection,to understand the economic burden caused by nosocomial infection,and to provide scientific basis for the rational utilization of medical and health resources.MethodsFrom January 1,2018 to December 31,2018,534 patients with gastric cancer surgery admitted to the hospital in accordance with the inclusion criteria were selected as the research object.The survey of 534 patients undergoing gastric cancer surgery was investigated through the self-compiled questionnaire on monitoring of nosocomial infection in patients undergoing gastric cancer surgery and the questionnaire on economic burden of nosocomial infection in patients undergoing gastric cancer surgery.The patient’s demographic data,tumor situation,operation situation and other relevant data,the incidence of nosocomial infection in patients undergoing gastric cancer surgery,the location of occurrence,pathogen detection and other specific conditions,as well as the economic burden of the disease caused by nosocomial infection were investigated.The related factors of nosocomial infection in patients with gastric cancer surgery were analyzed by single factor statistical analysis,and logistic regression model was used for multifactorial analysis.The data obtained from the study was statistical analyzed by the statistical software package version 21.0(Statistical Package for Social Sciences,Version 21.0,SPSS 21.0).T test or Mann-Whitney U test were used to compare counting data that conform to normal distribution and do not conform to normal distribution,respectively.And chi-square,Fisher exact probability method was used for comparison of counting data.In addition,the economic burden caused by nosocomial infection in patients with gastric cancer surgery was calculated by the tendency score weighting method.after 1:1 tendency condition matching,the wilcoxon rank sum test was used to compare the economic burden caused by nosocomial infection.Results1.In this study,a total of 534 patients with gastric cancer surgery were included,of which 400 were male(74.9%),134 were female(25.1%),and the ratio of male to female was 2.99:1.The average age of the patients was(59.56±10.43)years,of which 292 were selected for laparotomy(54.70%),234 for laparoscopic surgery(43.80%)and 8 for laparoscopic transit to open surgery(1.5%).2.There were 67 cases of nosocomial infection after gastric cancer operation,8 of them had multi-site infection,the nosocomial infection rate was 12.55%,and the case nosocomial infection rate was 14.04%.The infection site included 37 cases of surgical site infection,accounting for 49.33%;followed by 31 cases of pulmonary infection,accounting for 41.33%;4 cases of septicemia,accounting for 5.33%;1 case of urinary tract infection and 1 case of upper respiratory tract infection,each accounting for 1.33%..3.The positive rate of 31 strains of pathogenic bacteria was 81.59%.Among them,21 strains of gram negative bacteria were detected,accounting for 67.74%;8 strains of Gram positive bacteria,accounting for 25.81%;and 2 strains of fungi,accounting for 6.45%.4.Single factor and logistic multifactorial regression analysis revealed that the days of abdominal drainage tube indwelling,peak postoperative temperature on operative day(>37℃),postoperative complications,secondary surgery,local chemotherapy in abdominal cavity at the end of operation and laparoscopic transfer laparotomy were the six independent risk factors for nosocomial infection in patients with gastric cancer after operation.5.Because of nosocomial infection,the average hospital stay of patients with gastric cancer surgery was extended by 10 days,resulting in a total direct economic burden of 32522.04 yuan,of which the cost of sanitary materials,western medicine and treatment increased the most,resulting in an indirect economic burden of 3730.00 yuan and an overall economic burden of 36252.04 yuan.Among them,the economic burden of patients with gastric cancer surgery with multiple parts of infection was the highest.Conclusions(1)The patients with gastric cancer surgery have a higher incidence of nosocomial infection due to their poor physical function and the large surgical trauma,among which the highest proportion of infection occurred at the surgical site.And the days of abdominal drainage tube indwelling,peak postoperative temperature on operative day(>37℃),postoperative complications,secondary surgery,local chemotherapy in abdominal cavity at the end of operation and laparoscopic transfer laparotomy are the six independent risk factors for nosocomial infection in patients with gastric cancer after operation.(2)After nosocomial infection occurs in patients undergoing gastric cancer surgery,prolonged hospitalization will result in additional direct medical expenses and an indirect economic burden.Therefore,clinical intervention can be carried out according to the relevant risk factors,and effective prevention and control strategies can be adopted to avoid the occurrence of nosocomial infection to increase the patient’s disease economic burden. |
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