肝癌患者术后肺部感染的危险因素分析

Risk factors of postoperative pulmonary infections in liver cancer patients

目的分析肝癌手术患者术后肺部感染的危险因素,探讨防治该类感染发生的措施。方法选取210例行手术治疗的肝癌患者为观察对象,根据是否并发肺部感染进行分组比较相关指标,探讨肝癌患者术后并发肺部感染的相关危险因素。结果并发肺部感染组患者既往吸烟患者占42.55%,既往慢性呼吸道疾病史患者占53.19%,术前低蛋白血症患者占23.40%,术前进行深静脉穿刺患者占36.17%,均高于未并发肺部感染组,比较差异有统计学意义(P<0.05);并发肺部感染组术后使用镇痛泵患者占21.28%,低于未并发肺部感染组,比较差异有统计学意义(P<0.05);并发肺部感染组患者术前住院时间为(7.2±1.4)d,手术时间为(186.4±32.5)min,术中气管插管时间(162.1±17.8)min,术中出血量为(1264.8±150.7)ml,术后留置鼻胃管时间为(12.5±4.5)d,术后呼吸机使用时间为(4.5±2.4)d,均大于未并发肺部感染组,差异有统计学意义(P<0.05)。结论既往吸烟史、慢性肺部疾病史、术前低蛋白血症、术前住院时间较长、术前进行深静脉穿刺、手术时间较长、术中气管插管时间较长、术中出血量较大、术后不使用镇痛泵、术后长时间留置鼻胃管时间和使用呼吸机均是肝癌患者术后并发肺部感染的相关危险因素,针对相关危险因素采取相应防治措施有利于减少术后肺部感染的发生。

OBJECTIVE To analyze the risk factors of postoperative pulmonary infections in the liver cancer patients and to explore the measures of prevention and control of such infections. METHODS A total of 210 cases of patients with hepatocellular carcinoma,who underwent the surgical treatment,were selected as the observation objects,the related indexes were compared on the basis of the status of concurrent pulmonary infections,and the related risk factors of the postoperative pulmonary infections in the liver cancer patients were explored. RESULTS In the concurrent lung infection group,the percentage of the smoking patients was 42.55%,the percentage of patients with chronic respiratory disease history was 53.19%,the percentage of preoperative hypoalbuminemia patients was 23.40%,the percentage of patients who underwent preoperative deep vein puncture was 36.17%,which were higher than that of the concurrent lung infection group,the difference was statistically significant（P〈0.05）;the percentage of patients with postoperative analgesia pump in the concurrent lung infection group was 21.28%,lower than that of the non-concurrent lung infection group,the difference was statistically significant（P〈0.05）;the preoperative hospitalization duration of the concurrent lung infection group was（7.2±1.4）d,the operation duration（186.4±32.5）min,the intraoperative endotracheal intubation duration（162.1±17.8）min,the intraoperative bleeding amount（1264.8±150.7）ml,the duration of postoperative indwelling nasogastric intubation（12.5±4.5）d,and the duration of postoperative use of ventilator（4.5±2.4）d,all of which were significantly greater than those of the non-concurrent pulmonary infection group,the difference was statistically significant（P〈0.05）.CONCLUSION The smoking history,chronic lung disease history,preoperative hypoalbuminemia,long duration of preoperative hospitalization,preoperative deep vein puncture,long operation duration,long duration of intraoperative endotracheal intubation,the large amount of intraoperative bleeding,not using the analgesia pump after surgery,the long duration of indwelling nasogastric tube,and use of ventilator are all the risk factors associated with the postoperative pulmonary infections in the liver cancer patients.