喉癌患者术后感染与肺功能减损的相关性研究  

Study of the correlation between tracheal infections of throat cancer patients after surgery and lung function impairment

作　　者：李军[1] 杜月赞 霍玉峰[3] 

机构地区：[1]菏泽市立医院耳鼻咽喉科,山东菏泽274031 [2]菏泽市中医医院耳鼻喉科,山东菏泽274031 [3]山东省胸科医院心外科,山东济南250013

出　　处：《中华医院感染学杂志》2015年第11期2565-2566,2575,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(Y2005C36)

摘　　要：目的研究喉癌患者实施全切手术后气管感染和肺功能减损的相关性,以降低术后感染率。方法选取2011年2月-2013年2月接受全切手术的喉癌患者96例,其中52例患者行单纯喉癌全切术、44例患者行喉癌全切与颈淋巴结清扫,分析术后气管感染率及气管感染对肺功能减损与肿瘤复发的影响,数据采用SPSS13.0统计软件进行分析。结果行单纯喉癌全切术患者气管感染率为7.69%,行喉癌全切术与颈淋巴结清扫患者气管感染率为27.27%,两者比较差异有统计学意义（P〈0.05）,手术时间4-6h患者气管感染率为18.18%,较手术时间〉6h患者的57.14%显著更低,差异有统计学意义（P〈0.05）;16例气管感染患者经测定发现,术后1s用力呼气容积（FEV1）为（67.09±4.01）%,较术前的（59.57±2.83）%显著更高;术后25%肺活量最大呼气流量为（0.69±0.40）L/s,较术前的（1.01±0.20）L/s显著更低,差异均有统计学意义（P〈0.05）;肿瘤复发率感染患者为6.25%,未感染患者为8.75%,两者比较差异无统计学意义。结论喉癌患者实施全切手术后容易引发感染及肺功能减损,应采取相应措施避免其发生。OBJECTIVE To study the correlation between tracheal infections of throat cancer patients after surgery and lung function impairment ,so as to reduce postoperative infection rates .METHODS From Feb .2011 to Feb . 2013 ,96 cases with throat cancer and received full larynx resection were selected in our hospital .Among them ,52 patients underwent larynx resection alone ,and the other 44 patients with full larynx resection and cervical lymph node dissection .The influence of tracheal infection rate on lung function impairment and tumor recurrence were analyzed .The data were analyzed by SPSS 13 .0 software .RESULTS The laryngeal infection rate of patients underwent laryngeal resection alone was 7 .69% ,while in patients received full larynx resection and cervical lymph node dissection ,it was 27 .27% .The difference was significance （P〈 0 .05）;when the operating time was between 4-6 h ,the infection rate was 18 .18% ,but when the operating time 〉6 h ,the infection rate increased to a significant higher rate of 57 .14% .The difference was significant（P〈0 .05） .Postoperative airway infection was determined in 16 patients ,FEV1 （Forced expiratory volume in one second′s percent predicted ） was （67 .09 ± 4 .01）% ,which were remarkably higher compared with that of （59 .57 ± 2 .83）% before the operation .The postoperative （25% of the FVC exhaled gas flow rate） was （0 .69 ± 0 .40）L/s ,while the preoperative rate was （1 .01 ± 0 .20）L/s ,which was significantly higher （P〈0 .05） .The relapse rate of tracheal infection was 6 .25% in the infected patients , compared with the uninfected group of 8 .75% ,the difference was not significant . CONCLUSION The implementation of full laryngeal resection is apt to cause infections and pulmonary function impairment ,thus appropriate measures should be taken to prevent this .

关 键 词：喉癌 全切手术 气管感染 肺功能减损 

分 类 号：R619.3[医药卫生—外科学]