下咽癌切除术患者医院感染的危险因素分析

Risk factors for nosocomial infections in patients undergoing hypopharyngeal carcinoma resection

目的探讨下咽癌切除术患者术后发生医院感染的危险因素,为临床预防与控制感染提供参考。方法回顾性分析2007年12月-2013年6月耳鼻咽喉科行下咽癌切除手术80例患者的临床资料,找出患者行下咽癌切除术术后发生感染的差异有统计学意义的危险因素,并对危险因素进行非条件logistic回归分析,找出独立危险因素。结果 80例行下咽癌切除手术患者中,11例发生术后感染,感染率为13.75%;经logistic回归分析结果得出,基础疾病(β=0.898,OR=2.542)、抗菌药物使用(β=1.847,OR=5.584)、侵入性操作(β=2.135,OR=7.103)、术前放疗(β=2.007,OR=6.361)、营养不良(β=1.909,OR=5.866)是导致耳鼻咽喉科患者行下咽癌切除术术后发生感染的独立危险因素。结论基础疾病、抗菌药物使用、侵入性操作、术前放疗、营养不良是导致患者行下咽癌切除术后发生感染的独立危险因素,临床上应注意无菌操作,以及术后抗菌药物的合理使用,并加强患者自身免疫力,以降低术后感染率。

OBJECTIVE To explore the risk factors for postoperative nosocomial infections in patients undergoing hypopharyngeal carcinoma resection so as to provide guidance for clinical prevention and control of infections. METHODS The clinical data of 80patients who underwent the hypopharyngeal carcinoma resection in the department of otolaryngology from Dec 2007to Jun 2013were retrospectively analyzed,then the risk factors for the postoperative infections that had significant differences were found out,the non-conditional logistic regression analysis of the risk factors was performed to find out the independent risk factors.RESULTS Of the 80patients who underwent the hypopharyngeal carcinoma resection,the postoperative incision infections occurred in 11cases with the infection rate of 13.75%.The result of logistic regression analysis showed that the underlying disease（β=0. 898,OR=2.542）,use of antibiotics（β=1.847,OR=5.584）,invasive operation（β=2.135,OR=7.103）,preoperative radiotherapy（β=2.007,OR=6.361）,and malnutrition（β=1.909,OR=5.866）were the independent risk factors for the postoperative infections in the patients undergoing hypopharyngeal carcinoma resection. CONCLUSIONThe underlying disease,use of antibiotics,invasive operation,preoperative radiotherapy,and malnutrition are the independent risk factors for the postoperative infections in the patients undergoing hypopharyngeal carcinoma resection.It is necessary to pay attention to the aseptic operation and the reasonable postoperative use of antibiotics and intensify the immunity of the patients so as to reduce the incidence of postoperative infections.