口腔颌面恶性肿瘤术后手术部位感染的影响因素分析  

Analysis of influencing factors of surgical site infection after oral and maxillofacial malignancies surgery

作　　者：赵景杰 孙宝众 ZHAO Jingjie;SUN Baozhong(Stomatology Department,Binzhou Second People's Hospital,Binzhou 256800,China)

机构地区：[1]山东省滨州市第二人民医院口腔科,山东滨州256800

出　　处：《临床医学研究与实践》2025年第7期45-48,共4页Clinical Research and Practice

基　　金：山东省医药卫生科技发展计划项目(No.2021WS273)。

摘　　要：目的探讨口腔颌面恶性肿瘤(OMMs)患者术后手术部位感染(SSI)的影响因素。方法回顾性分析2020年1月至2023年12月本院收治的128例OMMs患者的临床资料,根据术后是否发生SSI将其分为感染组(29例)和对照组(99例)。比较两组的一般资料、肿瘤性质、血液指标、手术资料;采用单因素和多因素Logistic回归分析筛选OMMs患者术后SSI发生的影响因素;绘制限制性立方样条(RCS)探索计量资料与SSI发生的关系。结果对照组的体质量指数(BMI)、血清白蛋白水平高于感染组,手术方式(扩大切除+皮瓣修复术)、颈部淋巴结清扫术占比低于感染组(P<0.05)。Logistic回归分析结果显示,高BMI(OR=0.758,95%CI 0.604~0.951,P=0.017)和高水平血清白蛋白(OR=0.871,95%CI 0.798~0.952,P=0.002)是OMMs术后SSI发生的保护因素;颈部淋巴结清扫术(OR=7.101,95%CI 2.313~21.798,P<0.001)是OMMs术后SSI发生的危险因素。RCS结果显示,BMI、血清白蛋白与OMMs术后SSI发生均为线性关系,当BMI>22.85 kg/m^(2)时,OMMs术后SSI的发生风险显著降低;当血清白蛋白>38.20 g/L时,OMMs术后SSI的发生风险显著降低。结论BMI、血清白蛋白水平和颈部淋巴结清扫术是OMMs患者术后SSI发生的影响因素,在临床诊治中应加以重视。Objective To investigate the influencing factors of surgical site infection(SSI)in patients with oral and maxillofacial malignancies(OMMs)after surgery.Methods The clinical data of 128 patients with OMMs admitted in our hospital from January 2020 to December 2023 were retrospectively analyzed.According to whether SSI occurred after surgery,the patients were divided into infection group(29 cases)and control group(99 cases).The general data,tumor properties,blood indexes and surgical data of the two groups were compared;univariate and multivariate Logistic regression analysis were used to screen the influencing factors of SSI in patients with OMMs after surgery;restricted cubic spline(RCS)was drawn to explore the relationship between continuous variables and SSI.Results The body mass index(BMI)and serum albumin level in the control group were higher than those in the infection group,and the surgical methods(extended resection+flap repair)and proportion of cervical lymph node dissection were lower than those in the infection group(P<0.05).Logistic regression analysis results showed that high BMI(OR=0.758,95%CI 0.604-0.951,P=0.017)and high serum albumin(OR=0.871,95%CI 0.798-0.952,P=0.002)were protective factors for SSI after OMMs surgery,cervical lymph node dissection(OR=7.101,95%CI 2.313-21.798,P<0.001)was a risk factor for SSI after OMMs surgery.RCS results showed that BMI and serum albumin were linearly correlated with SSI after OMMs surgery,when BMI>22.85 kg/m^(2),the risk of SSI after OMMs surgery significantly reduced;when serum albumin>38.20 g/L,the risk of SSI after OMMs surgery significantly reduced.Conclusion BMI,serum albumin level and cervical lymph node dissection are the influencing factors of SSI in patients with OMMs after surgery,which should be taken seriously in clinical diagnosis and treatment.

关 键 词：口腔颌面恶性肿瘤 手术部位感染 体质量指数 血清白蛋白 颈部淋巴结清扫术 

分 类 号：R739.8[医药卫生—肿瘤]