食管癌及贲门癌术后肺部感染危险因素分析  

Risk factors of postoperative pulmonary infections in esophageal and cardiac cancer patients

作　　者：万清廉[1] 于洪涛[2] 侯向生[1] 

机构地区：[1]郑州人民医院胸外科,河南郑州450003 [2]郑州人民医院呼吸内科,河南郑州450003

出　　处：《中华医院感染学杂志》2013年第14期3416-3417,3420,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅科技攻关项目(2011030017)

摘　　要：目的分析食管癌及贲门癌术后肺部感染危险因素,探讨临床防治措施,为临床工作提供借鉴。方法选取医院2008年12月-2012年8月行食管癌、贲门癌手术切除且术后出现肺部感染患者30例临床资料,设为观察组,并以同期未出现肺部感染患者80例设为对照组,进行相关危险因素单变量及logistic回归多变量分析。结果对照组患者年龄、吸烟例数、合并低蛋白血症例数、病程、术中出血量、镇痛药物使用及合并慢性阻塞性肺疾病例数分别为(46.1±5.5)岁、15例、11例、(5.1±1.7)个月、(269.5±68.5)ml、7例、8例;观察组患者分别为(57.5±6.3)岁、16例、15例、(6.4±2.3)个月、(516.7±104.0)ml、9例、14例;两组间比较,差异有统计学意义(P<0.05);经logistic多变量回归分析证实术中出血量、低蛋白血症及慢性阻塞性肺疾病是食管癌贲门癌术后肺部感染独立危险因素。结论食管癌贲门癌术后肺部感染与患者术中出血量、合并低蛋白血症及慢性阻塞性肺疾病密切相关;临床医师应当加强围手术期感染防治工作以有效降低术后肺部感染发生风险。OBJECTIVE To analyze the risk factors of postoperative pulmonary infections and put forward prevention and treatment measures so as to guide the clinical treatment.METHODS A total of 110 patients,who underwent the esophageal and cardiac cancer resection in the hospital from Dec 2008 to Aug 2012,were enrolled in the study and were divided into the observation group with 30 cases of postoperative pulmonary infections and the control group with 80 cases without postoperative pulmonary infections,then the univariate analysis and the multivariate logistic regression analysis of the related risk factors.RESULTS The age,cases of smoking,cases of hypoproteinemia,duration,volume of intraoperative blood loss,use of analgesics,and chronic obstructive pulmonary disease of the control group were respectively（46.1±5.5）years,15cases,11cases,（5.1±1.7） months,（269.5±68.5）ml,7 cases,and 8 cases and were（57.5±6.3）years,16 cases,15 cases,（6.4±2.3） months,（516.7±104.0）ml,9 cases,and 14 cases in the observation group,the difference between the two groups was significant（P0.05）.The multivariate logistic regression analysis indicated that the intraoperative blood loss,hypoproteinemia,and chronic obstructive pulmonary disease were defined as the independent risk factors of pulmonary infections after the esophageal and cardiac cancer resection.CONCLUSION The postoperative pulmonary infections in the patients undergoing esophageal cancer and cardiac resection are related to the intraoperative blood loss,hypoproteinemia,and chronic obstructive pulmonary disease;the clinicians should strengthen the prevention of infections during the perioperative period so as to effectively reduce the incidence of postoperative pulmonary infections.

关 键 词：食管癌 贲门癌 肺部感染 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]