糖尿病合并原发性肝癌患者介入术后感染发生状况及其影响因素分析

目的分析糖尿病合并原发性肝癌患者介入治疗后发生感染的影响因素,以期指导未来临床该疾病介入治疗后防治感染方案的制定。方法回顾性分析,搜集2019年2月至2020年10月期间入院行介入治疗后发生感染的42例糖尿病合并原发性肝癌患者的临床资料,将其纳入感染组;另搜集同时间入院行介入治疗后未发生感染的40例糖尿病合并原发性肝癌患者的临床资料,将其纳入未感染组。记录并对比两组基线资料,找出可能导致糖尿病合并原发性肝癌患者介入治疗后发生感染的高危因素。结果将糖尿病合并原发性肝癌患者介入治疗后发生感染的情况作为因变量(1=发生,2=未发生),经Logistic回归分析显示,糖尿病病程、原发性肝癌病程、放化疗、Child-Pugh分级、围术期侵入性操作、贫血、胰岛素抵抗指数均可能是糖尿病合并原发性肝癌患者介入治疗后发生感染的影响因素(OR=73.667、85.500、61.667、380.00、74.000、218.667、68.889,P<0.05)。结论糖尿病病程(≥1年)、原发性肝癌病程(≥1年)、放化疗(是)、Child-Pugh分级、围术期侵入性操作(≥3次)、贫血(是)、胰岛素抵抗指数均可能是糖尿病合并原发性肝癌患者介入治疗后发生感染的影响因素,临床针对合并上述高危因素的患者,给予针对性干预治疗,对提高糖尿病合并原发性肝癌患者介入治疗效果,促进良性结局具有关键意义。

An analysis on the influencing factors of post-operative infection after interventional surgery in primary liver cancer patients with diabetes mellitus

Objective To analyze the influencing factors of infection after interventional treatment of primary liver cancer patients with diabetes mellitus,so as to establish a prevention and treatment plan for the post-operative infection in the future.Methods The clinical data of 42 patients with primary liver cancer complicated with diabetes mellitus who were infected after interventional therapy from February 2019 to October 2020 were retrospectively analyzed and enrolled into the infection group;the clinical data of 40 patients with diabetes mellitus and primary liver cancer who did not get infection after interventional surgery at the same period of time were collected and enrolled into the non-infection group.Single and multi-variant analyses were performed on the baseline data of these two groups of patients to find out the influencing factors of infection post interventional therapy.Results The binary variables including duration of diabetes,duration of primary liver cancer,radiotherapy and chemotherapy,Child-Pugh classification,perioperative invasive operation,anemia and index of insulin resistance obtained by single variant analysis were taken as independent variables,and the incidence of infection in patients with diabetes mellitus complicated with primary liver cancer after interventional therapy was taken as a dependent variable(1=occurred,2=not occurred).It was shown that the course of diabetes mellitus,the course of primary liver cancer,radiotherapy and chemotherapy,Child-Pugh classification,perioperative invasive operation,anemia,insulin resistance were the influencing factors of post-operative infection after interventional therapy in primary liver cancer patients with diabetes mellitus(OR=73.667,85.500,61.667,380.00,74.000,218.667,68.889,P<0.05[gh1]).Conclusion The course of diabetes(≥1 year),the course of primary liver cancer(≥1 year),radiotherapy and chemotherapy(yes),child Pugh classification,perioperative invasive operation(≥3 times),anemia(yes),and the existence of insulin resistance were the influencing factors of infection after interventional surgery in primary liver cancer patients with diabetes mellitus.It is important to take protective strategies in these patients for improving their outcome after interventional therapy.