高龄食管癌患者术后肺部感染的相关因素分析  

Related factors for postoperative pulmonary infections in elderly patients with esophageal cancer

作　　者：姚源山 沈海波[1] 黄鸿渤 杨振华[1] 周银杰[1] 胡天军[1] YAO Yuan-shan, SHEN Hai-bo, HUANG Hong-bo, YANG Zhen-hua, ZHOU Yin-jie, HU Tian-jun(The Second Hospital, Ningbo , Ningbo , Zhejiang 315001, Chin)

机构地区：[1]宁波市第二医院胸外科,浙江宁波315001

出　　处：《中华医院感染学杂志》2018年第6期887-889,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫计委医药卫生科技计划基金资助项目(2015KYB325)

摘　　要：目的分析高龄食管癌患者术后肺部感染的相关因素,为临床治疗提供参考。方法回顾性分析2010年3月-2017年3月收治的108例高龄食管癌患者临床资料,所有患者均实施手术治疗,统计患者术后肺部感染率,分析术后肺部感染的相关因素。结果 108例患者术后发生肺部感染40例,感染率为37.04%,手术时间>4h、失血量>800ml、喉返神经损伤、胃食管反流、术后使用PCEA、有吸烟史及糖尿病为高龄食管癌患者术后肺部感染的相关因素,将以上有统计学意义的因素引入回归分析模型,食管癌术后肺部感染影响因素包括失血量>800ml、喉返神经损伤、胃食管反流、术后使用PCEA、有吸烟史及糖尿病。结论高龄食管癌患者术后肺部感染相关因素较多,术前应积极改善患者基础状况,术中避免神经损伤,减少术后肺部感染发生率。OBJECTIVE To analyze the related factors for postoperative pulmonary infections in elderly patients with esophageal cancer so as to provide guidance for clinical treatment.METHODS The clinical data of 108 elderly patients with esophageal cancer who were treated from Mar 2010 to Mar 2017 were retrospectively analyzed,all of the patients received surgical procedures,the incidence of postoperative pulmonary infection was statistically analyzed,and the related factors for the postoperative pulmonary infections were observed.RESULTS Of the 108 patients,40 had postoperative pulmonary infections,with the infection rate 37.04%.The related factors for the postoperative pulmonary infection in the elderly patients with esophageal cancer included the operation duration more than 4 hours,blood loss volume more than 800 ml,recurrent laryngeal nerve injury,gastroesophageal reflux,postoperative use of PCEA,smoking history and diabetic mellitus,the above factors that had significance were introduced to regression analysis model,and the influencing factors for the postoperative pulmonary infections in the patients with esophageal cancer included the blood loss volume more than 800 ml,recurrent laryngeal nerve injury,gastroesophageal reflux,postoperative use of PCEA,smoking history and diabetic mellitus.CONCLUSIONThere are a variety of related factors for the postoperative pulmonary infections in the elderly patients with esophageal cancer.It is necessary to actively improve the basic condition of the patients before surgery and avoid the nerve injury during the surgery so as to reduce the incidence of postoperative pulmonary infections.

关 键 词：高龄食管癌 术后肺部感染 相关因素 围手术期 

分 类 号：R563.1[医药卫生—呼吸系统]