食管癌及贲门癌患者术后感染的原因分析及防治对策

Postoperative infection in patients with esophageal and cardia cancer

目的:分析食管癌及贲门癌患者术后感染的原因和防治对策。方法:回顾性分析2010年9月-2013年12月进行手术治疗的86例食管癌及贲门癌患者。采用不同防治感染对策后,分别观察两组食管及贲门癌患者术后感染的情况,分析原因进行统计学分析。结果:分析食管及贲门癌术后感染的30例患者的感染部位,手术切口感染16.3%,肺部感染12.8%,胸腔感染3.5%,泌尿系统感染2.3%,总感染率34.9%;食管及贲门癌术后感染的部位主要常见于手术切口及肺部。单因素分析后发现,感染因素与吸烟、手术时间(>2h)、术中失血量(>200ml)均有关(P<0.05)。43例患者常规抗感染治疗后,感染者占53.5%,未感染者占46.5%;43例患者早期防治术后感染后,感染者占16.3%,未感染者占83.7%;试验组的感染状况明显低于对照组(P<0.05)。结论:食管及贲门癌患者术后感染主要分布在肺部和切口处,原因复杂,临床手术中早期抗感染治疗可显著降低感染风险。

Objective：To analyze the causes and prevention of esophageal and gastric cardia patients with postoperative infection.Methods：All 86 cases of esophageal and gastric cardia patients were analyzed.After using different infection prevention measures,the two groups were observed in patients with esophageal and gastric cardia postoperative infection.Results：Site of infection in 30 patients with postoperative infections,surgical wound infection in 16.3%,12.8%,pulmonary infection,chest infection 3.5%,2.3%,urinary tract infections,the overall infection rate was 34.9%,esophagus and cardia postoperative infection common in parts of major surgical incision and lungs.Infection was associated with smoking,operative time,intraoperative blood loss were related （P 〈 0.05）.43 patients after conventional anti-infection treatment,infection accounted for 53.5%,46.5% not infected,early prevention of postoperative infection in 43 patients,accounting for 16.3% of those infected,uninfected accounted for 83.7% ; Infection in the test group was significantly lower than the control group（P 〈 0.05）.Conclusion：Patients with esophageal and gastric cardia postoperative infections mainly in the lungs and the incision,causes were complex,early anti-infection treatment can significantly reduce the risk of infection.