Ⅱ类切口头颈癌患者术后头颈部手术部位感染危险因素分析  

Analysis of risk factors for postoperative head and neck surgical site infection in patients with typeⅡincision head and neck cancer

作　　者：谢玲[1] 邹秋玉[2] 李文娟[1] 周芬 刘彬 XIE Ling;ZOU Qiuyu;LI Wenjuan;ZHOU Fen;LIU Bin(Department of Otolaryngology Head and Neck Surgery,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 41007,China;Department of Acupuncture and Tuina Rehabilitation,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 41007,China;Department of Nursing,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 41007,China)

机构地区：[1]湖南中医药大学第一附属医院耳鼻喉头颈外科,湖南长沙410007 [2]湖南中医药大学第一附属医院针灸推拿康复科,湖南长沙410007 [3]湖南中医药大学第一附属医院护理部,湖南长沙410007

出　　处：《西部医学》2022年第9期1335-1341,共7页Medical Journal of West China

基　　金：湖南省中医药管理局项目(D2022058)。

摘　　要：目的探讨Ⅱ类切口头颈癌患者术后头颈部手术部位感染的危险因素。方法回顾性分析2018年1月~2019年12月在本院耳鼻喉头颈肿瘤外科接受手术治疗的头颈癌患者的临床资料。采用卡方检验、Mann-Whitney U检验及多因素logistic回归分析的方法分析手术部位感染的危险因子,并采用机器学习的方法对危险因素的权重进行排序。结果共有432例头颈癌手术患者符合纳入标准,术后有73例患者发生手术部位感染,感染率约为15.77%。糖尿病、原发肿瘤部位(口底)、皮瓣失败、术前放疗及双侧颈淋巴结清扫是头颈癌术后感染的危险因子。采用机器学习的方法对手术部位感染的可能危险因素进行权重分析后发现:糖尿病、原发肿瘤部位(口底)、皮瓣失败是排名前三的可能造成手术部位感染的危险因子。此外,手术部位感染可明显增加患者住院日及皮瓣失败的风险。结论糖尿病、肿瘤部位(口底)、皮瓣失败、术前放疗以及双侧颈部淋巴结清扫是头颈癌术后感染的危险因子。Objective To explore the risk factors of postoperative head and neck surgical site infection in patients with typeⅡincision head and neck cancer.Methods Retrospective analysis of the clinical data of patients with head and neck cancer who underwent surgical treatment in the department of ENT in our hospital from January 2018 to December 2019.Risk factors for surgical site infection were analyzed using chi-square test,Mann-Whitney U test,and multivariate logistic regression analysis,and Machine learning methods are used to rank the weights of risk factors.Results A total of 432 patients with head and neck cancer surgery met the inclusion criteria,and 73 patients developed surgical site infections after surgery,with an infection rate of about 15.77%.Diabetes mellitus,primary tumor site(base of the mouth),flap failure,preoperative radiotherapy,and bilateral cervical lymph node dissection are risk factors for postoperative infection of head and neck cancer.After weight analysis of the possible risk factors for surgical site infection using machine learning,it was found that diabetes,primary tumor site(bottom of the mouth),and flap failure are the top three risk factors that may cause infection at the surgical site.In addition,surgical site infection can significantly increase the risk of hospital stays and flap failure.Conclusion Diabetes mellitus,tumor site(base of the mouth),flap failure,preoperative radiotherapy,and bilateral cervical lymph node dissection are risk factors for postoperative infection of head and neck cancer.

关 键 词：头颈癌 手术部位感染 糖尿病 肿瘤部位 皮瓣失败 

分 类 号：R739.91[医药卫生—肿瘤]