老年肺癌患者围术期抗菌药物使用及术后肺部感染危险因素分析

Analysis on Perioperative Application of Antibiotics and Risk Factors of Postoperative Lung Infections in Elderly Lung Cancer Patients

目的:了解老年(>70岁)肺癌患者围术期应用抗菌药物的现状及术后肺部感染的危险因素,为临床合理用药提供参考。方法:回顾性收集2012年5月-2013年5月某院出院的行手术治疗的老年肺癌病历248例,统计围术期抗菌药物使用情况,对术后发生肺部感染的可能危险因素进行单因素分析及多因素非条件Logistic回归分析。结果:在248例老年肺癌手术患者中,抗菌药物预防使用率为100%,抗菌药物品种为3种,使用天数基本控制在2 d以内(占78.22%)。术后肺部感染例数为86例(34.67%),2例(0.81%)死于术后肺部感染,术后感染的发生率与围术期抗菌药物的使用时间无关(P>0.05)。第1秒用力呼气量占预计值百分比(FEV1%)<70%、肺癌晚期以及糖尿病为老年肺癌患者发生术后肺部感染的危险因素。结论:老年肺癌患者围术期抗菌药物使用基本合理,术前半小时单剂量给药不会增加患者术后肺部感染的发生率。老年肺癌患者医院感染率较高,应针对其危险因素重点防控。

OBJECTIVE： To investigate the perioperative application of antibiotics and the risk factors of postoperative lung infections in elderly（ 〉 70 years） lung cancer patients, and to provide reference for rational drug use in the clinic. METHODS： Medical records of 248 lung cancer patients in a hospital between May 2012 and May 2013 were collected retrospectively. The perioperarive application of antibiotics was investigated. Single factor analysis and multiple factor non-conditional Logistic regression were conducted for potential risk factors of postoperative lung infections. RESULTS： Among 248 elderly patients with lung cancer operation, prophylactic use of antibiotics accounted for 100%, 3 varieties were used and about 78.22% of patients were treated with antibiotics within 2 days. Postoperative lung infections developed in 86 patients （34.67%）. 2 patients （0.81%） died from it. The incidence of postoperative infection didn＇t dependent on medication duration of antibiotics during perioperative period （P〉0.05）. FEV1% 〈7.0%, advanced lung cancer and lung cancer complicating with diabetes mellitus before operation were risk factors of postoperative lung infections in elderly patients. CONCLUSIONS： Perioperative use of antibiotics in the elderly patients with lung cancer is rational. Half an hour before operation, single dose administration dose not increase the incidence of lung infection after operation. The incidence of lung infection in elderly patients with lung cancer is in high level, and prevention and control should be taken according to related risk factors.