呼吸道微生物定植与非小细胞肺癌患者根治术后肺炎发生的相关性分析  

Correlation between Respiratory Tract Microbial Colonization with Occurrence of Pneumonia in Patients with Non-small Cell Lung Cancer after Radical Resection

作　　者：尤雷[1] 翟俊伟[3] 刘艳虹 吴国峰 邸庆国[2] YOU Lei;ZHAI Jun-wei;LIU Yan-hong;WU Guo-feng;DI Qing-guo(Department of General Internal Medicine,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Respiratory and Critical Care,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Clinical Laboratory,Fengnan District Hospital,Tangshan,Hebei 063300,China)

机构地区：[1]沧州市中心医院综合内科,河北沧州061000 [2]沧州市中心医院呼吸与危重症科,河北沧州061000 [3]唐山市丰南区医院检验科,河北唐山063300

出　　处：《解放军医药杂志》2022年第3期10-13,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省医学科学研究课题计划项目(20211288)。

摘　　要：目的研究呼吸道微生物定植与非小细胞肺癌(NSCLC)患者根治术后肺炎发生的相关性。方法收集2019年4月—2021年4月146例NSCLC临床资料,患者均接受NSCLC根治术,记录术后肺炎发生率和病原菌分布情况。患者均在术前经支气管镜取样检测呼吸道微生物定植情况,采用多因素Logistic回归分析探讨呼吸道微生物定植与NSCLC术后肺炎发生的关系。结果146例术前存在呼吸道微生物定植56例(38.36%),术后发生肺炎38例(26.03%)。术后发生肺炎38例病原菌中革兰阴性菌28株(73.68%),革兰阳性菌10株(26.32%)。多因素Logistic回归分析显示,合并慢性阻塞性肺疾病、手术时间及术前呼吸道微生物定植是肺炎发生的独立危险因素(P<0.05,P<0.01)。结论术前呼吸道微生物定植是NSCLC根治术后肺炎发生的独立危险因素,术后肺炎病原菌以革兰阴性菌为主。Objective To study the correlation between respiratory tract microbial colonization with occurrence of pneumonia in patients with non-small cell lung cancer(NSCLC)after radical resection.Methods Clinical data of 146 patients with NSCLC between April 2019 and April 2021 was collected.All patients underwent radical resection of NSCLC,and incidence rate of postoperative pneumonia and distribution of pathogenic bacteria were recorded.Samples of all patients were collected by bronchoscope before operation to detect the microbial colonization of respiratory tract.Multivariate Logistic regression analysis was used to explore correlation between microbial colonization of respiratory tract with pneumonia after operation for NSCLC.Results Among the 146 patients,56 patients(38.36%)had respiratory tract microbial colonization before operation,and 38 patients(26.03%)had pneumonia after operation.Among 38 patients with postoperative pneumonia,there were 28 strains of gram-negative bacteria(73.68%)and 10 strains of gram-positive bacteria(26.32%).Multivariate Logistic regression analysis showed that combined with chronic obstructive pulmonary disease,operative duration and preoperative respiratory tract microbial colonization were independent risk factors for occurrence of postoperative pneumonia(P<0.05,P<0.01).Conclusion Preoperative respiratory tract microbial colonization is an independent risk factor for occurrence of pneumonia after radical resection in NSCLC patients.The main pathogens of postoperative pneumonia are gram-negative bacterium.

关 键 词：癌 非小细胞肺 肺癌根治术 肺炎 呼吸道微生物 影响因素分析 

分 类 号：R734.2[医药卫生—肿瘤]