食管及贲门癌患者术后感染危险因素研究

Risk factors for postoperative infections in esophageal and cardia cancer patients

目的探讨食管、贲门癌患者术后感染危险因素,为疾病诊治和术后感染预防提供依据。方法对医院2009年1月-2012年12月收治的620例食管、贲门癌患者进行回顾性分析,分析其术后感染率、感染部位和病原菌分布;选择性别、年龄、吸烟等16个变量进行单因素回归分析,并应用logistic回归分析分析食管、贲门癌术后感染的危险因素。结果 620例食管、贲门癌患者术后感染率为13.2%,其中切口、肺部、胸腔感染率分别占41.5%、46.3%、3.7%;经单因素logistic回归分析,吸烟、糖尿病、手术方式、术后发热、术后白细胞、肿瘤部位和肺部疾病7个变量与术后感染相关(P<0.05);经多因素logistic回归分析,吸烟、手术方式、术后发热和肺部疾病4个变量是食管、贲门癌患者术后感染独立危险因素(P<0.05)。结论食管、贲门癌患者术后感染发病率较高,吸烟、糖尿病、手术方式、术后发热、术后白细胞、肿瘤部位和肺部疾病等与术后感染有关,针对以上因素应积极采取有效措施,降低术后感染发生率。

OBJECTIVE To explore the risk factors for postoperative infections in the patients with esophageal and cardia cancer so as to provide bases for the diagnosis and treatment as well as the prevention of postoperative infections.METHODS A total of 620esophageal and cardia carcinoma patients who were treated in the hospital from Jan 2009to Dec 2012were retrospectively analyzed,the incidence of postoperative infections and the distribution of infection sites and the pathogens were analyzed,then the univariate regression analysis was performed for the 16 variables including the gender,age,smoking and so on;the logistic regression analysis was performed for the risk factors for the postoperative infections in the patients with esophageal and cardia cancer.RESULTS Of the 620 cases of patients with esophageal and cardia cancer,the incidence rate of postoperative infections was 13.2%;among the patients with postoperative infections,the patients with incision infections accounted for 41.5%,the patients with pulmonary infections 46.3%,the patients with pleural infections 3.7%.The univariate logistic regression analysis showed that the smoking,diabetes mellitus,operation mode,postoperative fever,postoperative WBC,location of tumor,and lung were the seven variables associated with the postoperative infections（P 0.05）;the multivariate logistic regression analysis indicated that the smoking,operation mode,postoperative fever,and pulmonary diseases were the 4independent risk factors for the postoperative infections in the patients with esophageal and cardia carcinoma（P0.05）.CONCLUSIONThe incidence of postoperative infections is high in the patients with esophageal and cardia carcinoma;the smoking,diabetes mellitus,operation mode,postoperative fever,postoperative WBC,location of tumor,and lung diseases are associated with the postoperative infections.It is necessary to take effective measures according to the above factors so as to reduce the incidence of postoperative infections.