老年非小细胞肺癌患者术后肺炎危险因素

目的 了解老年非小细胞肺癌患者发生术后肺炎的危险因素，探讨预防对策。方法 回顾性分析2016年1月-2018年11月某院接受手术治疗的70岁以上老年非小细胞肺癌患者的病例资料，统计分析术后肺炎发生情况、病原菌分布，并对相关危险因素进行分析。结果 398例肺癌手术患者中发生术后肺炎36例，感染率为9.05%；检出病原菌43株，其中革兰阴性菌20株（占46.51%），革兰阳性菌9株（占20.93%），真菌14株（占32.56%）。多因素logistic回归分析结果显示，年龄≥ 75岁、合并COPD、FEV₁%<70、开胸手术、肺叶手术、手术时长≥ 180 min、血清清蛋白<35 g/L是导致术后肺炎的独立危险因素（均P<0.05）。结论 老年非小细胞肺癌患者术后肺炎发病率高，影响因素多，应针对危险因素做好相应的预防控制措施，降低术后肺炎的发生率。

Risk factors for postoperative pneumonia in elderly patients with non-small cell lung cancer

Objective To understand the risk factors for postoperative pneumonia in elderly patients with non-small cell lung cancer(NSCLC), and explore the preventive measures. Methods Clinical data of surgical patients aged>70 years and with NSCLC in a hospital from January 2016 to November 2018 were retrospectively analyzed, incidence of postoperative pneumonia, distribution of pathogens, and related risk factors were analyzed statistically. Results Among 398 lung cancer surgical patients, 36 had postoperative pneumonia, infection rate was 9.05%; 43 strains of pathogens were isolated, including 20 strains (46.51%) of gram-negative bacteria, 9 strains(20.93%) of gram-positive bacteria and 14 strains (32.56%) of fungi. Multivariate logistic regression analysis showed that age ≥ 75 years, chronic obstructive pulmonary disease (COPD), forced expiratory volume in one second (FEV₁)% <70, thoracotomy, lobectomy, duration of operation ≥ 180 minutes, serum albumin <35 g/L were independent risk factors for postoperative pneumonia (all P<0.05). Conclusion Incidence of postoperative pneumonia in elderly patients with NSCLC is high and with multiple influencing factors, corresponding preventive and control measures should be taken to reduce the incidence of postoperative pneumonia.