鼻内镜手术患者感染的相关因素分析  

Analysis of related factors of infections in patients with nasal endoscopic surgery

作　　者：史凌改[1] 刘军[1] 王广科[1] 刘飞[1] 张文奇[1] 万保罗[1] SHI Ling-gai LIU Jun WANG Guang-ke LIU Fei ZHANG Wen-qi WAN Bao-luo(Henan Province People＇s Hospital, Zhengzhou, Henan 450003, Chin)

机构地区：[1]河南省人民医院耳鼻喉科,河南郑州450003

出　　处：《中华医院感染学杂志》2017年第12期2783-2785,2789,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究鼻内镜手术患者感染风险因素,旨在降低术后感染率,促进患者早日康复。方法选取2010年9月-2016年8月在医院行鼻内镜手术患者2 934例,回顾性观察患者性别、年龄、基础疾病、疾病分类、吸烟史、肥胖或营养不良、放化疗史、麻醉方法、手术时间、切口类型、术前抗菌药物使用、术后抗菌药物使用时间和住院时间,引入二分类logistic回归模型分析鼻内镜手术感染高危风险因素,研究其相关性。结果 2 934例鼻内镜手术患者,发生感染28例、感染率0.95%,鼻部肿瘤、鼻中隔偏曲患者感染率高于鼻息肉、慢性鼻窦炎患者,且鼻部肿瘤患者感染率高于鼻中隔偏曲患者,差异均有统计学意义(P<0.05);基础疾病(糖尿病)、吸烟、肥胖或营养不良、放化疗、麻醉方法、手术时间、切口类型、术前抗菌药物使用和住院时间为患者感染的危险因素;logistic回归模型显示,糖尿病、吸烟史、肥胖或营养不良、放化疗史、麻醉方法、手术时间、切口类型、住院时间是鼻内镜手术者感染的高危独立风险因素,而术前抗菌药物使用是鼻内镜手术感染的唯一保护因素。结论鼻内镜手术患者感染风险因素较多,定期积极筛查鼻内镜手术感染因素,明确风险,早期采取有效措施最大限度控制手术感染,提高手术疗效。OBJECTIVE To investigate the risk factors of infections in patients with nasal endoscopic surgery,so as to reduce the rate of postoperative infections and promote the early rehabilitation of patients.METHODS From Sep.2010 to Aug.2016,2934 cases of patients with nasal endoscopic surgery were selected.The genders,age,underlying diseases,disease classification,smoking history,obesity or malnutrition,radiotherapy and chemotherapy history,anesthesia methods,operation time,incision types,preoperative antimicrobial use,postoperative antimicrobial use time and length of stay were retrospectively observed.A binary logistic regression model was used to analyze the risk factors of nasal endoscopic surgery,and its correlation was analyzed.RESULTS Among 2 934 cases of patients with endoscopic sinus surgery,28 cases were infected,with the infection rate of 0.95 %.The infection rates of patients with nasal tumor and nasal septum deviation were significantly higher than those with the nose and chronic sinusitis,and the infection rate of patients with nasal tumor was significantly higher than that with nasal septum deviation （P〈0.05）.The prevalence of underlying diseases （diabetes）,smoking,obesity or malnutrition,radiotherapy and chemotherapy,anesthesia methods,operation time,incision types,preoperative antimicrobial use and hospital stay were risk factors for infection of patients （P〈0.05）.Logistic regression model showed that diabetes,smoking history,obesity or malnutrition,radiotherapy and chemotherapy history,anesthesia method,operation time,incision types,and hospitalization time were high-risk independent risk factors for infections of nasal endoscopic surgery,and the use of preoperative antimicrobial drugs was the only protective factor for nasal endoscopic surgery.CONCLUSION The risk factors of infection in patients with nasal endoscopic surgery are diverse,but regular positive screening of endoscopic infection factors,clear risks,early and timely to take effective measures can maximize control of surgical

关 键 词：鼻内镜 手术 感染 因素 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]