早期喉癌患者根治术后医院感染的易感因素分析与预防措施  

Predisposing factors for nosocomial infections in patients with early laryngeal cancer after radical surgery and prevention measures

作　　者：张贵[1] 袁泉良[2] 邵静[1] 赵静[3] 代密 

机构地区：[1]南阳市中心医院耳鼻咽喉科,河南南阳473000 [2]南阳市中心医院肛肠科,河南南阳473000 [3]南阳市中心医院神经内科,河南南阳473000

出　　处：《中华医院感染学杂志》2018年第2期236-238,272,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨和分析早期喉癌患者根治术后医院感染的易感因素及预防措施。方法选取2015年1月-2016年12月期间在医院施行喉癌根治术的278例早期喉癌患者作为临床研究对象,并对患者的性别、年龄、临床分期、基础疾病、手术时间、术中出血量、应用抗菌药物等相关因素统计和分析,并据此制定针对性的预防干预措施。结果 278例早期喉癌行根治性手术患者术后发生医院感染41例,感染率14.75%;早期喉癌患者根治术后感染类型以肺部感染及切口感染为主;年龄>60岁、临床分期Ⅱ期、基础疾病、手术时间>4h、术中出血量>20ml、应用抗菌药物均为早期喉癌患者根治术后医院感染的影响因素(P<0.05);经Logistic回归分析,临床分期、基础疾病以及应用抗菌药物是早期喉癌患者根治术后医院感染的独立影响因素(P<0.05)。结论早期喉癌患者根治术后医院感染与年龄、临床分期、基础疾病、手术时间、术中出血量、应用抗菌药物等因素相关,围术期应针对影响因素加强医院感染的预防和控制以降低医院感染的发生。OBJECTIVE To explore the predisposing factors for nosocomial infections in patients with early laryngeal cancer after radical surgery and put forward the prevention measures.METHODS A total of 278 patients with early laryngeal cancer who underwent the radical surgery of laryngeal cancer in the hospital from Jan 2015 to Dec2016 were recruited as the study objects.The related factors,including gender,age,clinical stages,underlying diseases,operation duration,volume of intraoperative blood loss and use of antibiotics,were statistically analyzed,and the targeted intervention measures were put forward.RESULTS Of the 278 patients with early laryngeal cancer who underwent the radical surgery,41 had postoperative nosocomial infections,with the infection rate14.75%;the patients with pulmonary infections and incision infections were dominant among the patients who had the postoperative infections.The influencing factors for the postoperative nosocomial infections in the patients with early laryngeal cancer included the more than 60 years of age,clinical stageⅡ,underlying diseases,operation duration more than 4 hours,intraoperative blood loss more than 20 ml and use of antibiotics（P〈0.05）.The logistic regression analysis showed that the clinical stage,underlying diseases and use of antibiotics were the independent influencing factors for the postoperative nosocomial infections in the early laryngeal cancer patients undergoing the radical surgery（P〈0.05）.CONCLUSIONThe incidence of postoperative nosocomial infections in the early laryngeal cancer patients undergoing the radical surgery is associated with the age,clinical stage,underlying diseases,operation duration,volume of intraoperative blood loss and use of antibiotics.It is necessary to strengthen the prevention and control of the nosocomial infections in response to the influencing factors during the perioperative period so as to reduce the incidence of the nosocomial infections.

关 键 词：喉癌 根治术 医院感染 易感因素 预防措施 

分 类 号：R619.3[医药卫生—外科学]