乳腺癌术后Ⅰ期假体植入乳房重建术患者术后感染预测模型构建及防控策略  

Prediction model construction and prevention and control strategy of postoperative infection in patients with immediate reconstruction by breast prosthesis after breast cancer surgery

作　　者：吴娟 郭丝锦 郝遥 郭程程 王廷 WU Juan;GUO Si-jin;HAO Yao;GUO Cheng-cheng;WANG Ting(The First Affiliated Hospital of Chinese PLA Air Force Military Medical University,Xi'an 710000,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院,陕西西安710000

出　　处：《中国消毒学杂志》2025年第1期38-41,共4页Chinese Journal of Disinfection

基　　金：陕西省自然科学基础研究计划项目(2021JZ-29)。

摘　　要：目的探讨乳腺癌术后Ⅰ期假体植入乳房重建术患者术后感染危险因素并构建预测模型,为制订术后感染防控策略提供参考。方法纳入某医院2021年1月—2023年12月收治的乳腺癌术后Ⅰ期假体植入乳房重建术患者160例,先行单因素分析,再行多因素logistic回归分析并构建Nomogram预测模型。结果单因素分析结果显示,感染组与未感染组患者在手术时间、皮瓣缺血、皮瓣坏死、假体外漏、异物反应、高血压、预防性运用抗菌药物、抗菌药物使用剂量、HGB、PT等差异有统计学意义(P<0.05)。手术时间、皮瓣缺血,皮瓣坏死/假体外漏,异物反应、预防性运用抗菌药物、抗菌药物使用剂量是乳腺癌术后Ⅰ期假体植入乳房重建术患者术后发生感染的危险因素。Nomogram预测模型AUC=0.800,诊断价值良好。结论乳腺癌术后Ⅰ期假体植入乳房重建术患者术后感染发生率较高,术后感染发生的危险因素较多,应针对危险因素及时采取防控措施,预测模型具有较高的临床价值。Objective To explore the risk factors of postoperative infection in patients with immediate reconstruction by breast prosthesis after breast cancer surgery and construct a predictive model,so as to provide reference for formulating strategies for prevention and control of postoperative infection.Methods A total of 160 patients with immediate reconstruction by breast prosthesis after breast cancer surgery were included in our hospital from January 2021 to December 2023.Univariate analysis was performed first,and then multivariate logistic regression analysis was performed to construct a Nomogram prediction model.Results Univariate analysis showed that there were statistically significant differences(P<0.05)between the infected group and uninfected group in terms of surgical time,skin flap ischemia,skin flap necrosis,prosthesis leakage,foreign body reactions,hypertension,prophylactic use of antibiotics,antibiotic dosage,HGB,and PT.The risk factors of postoperative infection in patients with immediate reconstruction by breast prosthesis after breast cancer surgery were operation time,skin flap ischemia,skin flap necrosis/prosthesis leakage,foreign body reaction,preventive use of antibiotics,and dosage of antibiotics.The Nomogram prediction model has an AUC of 0.800 and good diagnostic value.Conclusion The incidence of postoperative infection in patients with immediate reconstruction by breast prosthesis after breast cancer surgery is high,and there are many risk factors for postoperative infection.The prevention and control strategy should be taken in time for the risk factors,and the prediction model has high clinical value.

关 键 词：乳腺癌 Ⅰ期假体植入乳房重建术 术后感染 预测模型 防控策略 

分 类 号：R183.3[医药卫生—流行病学] R184[医药卫生—公共卫生与预防医学]