食管癌术后并发肺部感染的危险因素分析

目的探讨食管癌术后并发肺部感染的危险因素,以降低食管癌术后肺部感染的发生率。方法收集2010年1月~2013年1月我院治疗的食管癌患者80例,发生肺部感染10例,未发生肺部感染70例,对两组患者的相关因素,包括年龄、性别、吸烟史、吸烟时间、合并基础疾病、手术方法、手术时间、术前血红蛋白、术前放疗与否、术中喉返神经损伤与否、术前血清白蛋白、术中是否使用自控硬膜外镇痛(PCEA)情况进行对比分析。结果年龄≥60岁、合并基础疾病、术前营养不良(术前血红蛋白≤100g/L、白蛋白≤30g/L)、术前未进行化疗、行开胸手术、未使用PCEA、有吸烟史、吸烟时间≥20年的食管癌患者肺部感染发生率较高(P<0.05或P<0.01)。将上述单因素进行多因素非条件Logistic回归分析:年龄≥60岁、合并基础疾病、术前营养不良(术前血红蛋白≤100g/L、白蛋白≤30 g/L)、吸烟史、吸烟时间≥20年、术中喉返神经损伤是食管癌并发肺部感染的危险因素(P<0.05)。结论食管癌术后并发肺部感染的危险因素较多,在治疗食管癌的手术中应引起广大医生的重视,从而采取积极的措施进行预防和治疗。

The risk factors analysis of postoperative pulmonary infection

Objective To investigate the risk factors of postoperative pulmonary infection, in order to reduce the infection incidence rate of postoperative pulmonary. Methods From January 2010 to January 2013 in Our hospital,among 80 patients with esophageal cancer, 10 cases occurred lung infection,70 cases did not occur lung infection, the relevant factors included age, gender, smoking history, duration of smoking, underlying diseases, surgical procedures ,operative time, preoperative hemoglobin,preoperative radiotherapy or not,intraoperative recurrent laryngeal nerve injury, preoperative serum albumin,intraoperative use of controlled epidural analgesia （PCEA） cases were analyzed of two groups patients. Results Age ≥ 60 years of age ,underlying diseases ,preoperative malnutrition （preoperative hemoglobin ≤ 100 g/L,albumin ≤ 30 g/L）,preoperative chemotherapy, thoracotomy,unused PCEA,a history of smoking smoking time esophageal cancer patients ≥20 years had a higher incidence rate of lung infection （P〈0.05 or P 〈0.01）. The above univariate, multivariate Logistic regression analysis showed Age ≥ 60 years of age, underlying diseases, preoperative malnutrition （preoperative hemoglobin ≤ 100 g/L, albumin ≤ 30 g/L）, smoking history, smoking time≥ 20 years, intraoperative recurrent laryngeal nerve injury was risk factors for pulmonary infection＇of esophageal cancer （P 〈0.05）. Conclusion Postoperative pulmonary infection exist more risk factors ,in the treatment of esophageal cancer surgery should cause the majority of doctors attention ,in order to take positive measures for prevention and treatment.