头颈肿瘤患者行气管切开术后并发肺炎的回顾性分析

A Retrospective Analysis of Complicated Pulmonary Infection after Tracheostomy in Surgery for Head and Neck Oncology

目的了解头颈肿瘤患者行气管切开术后并发肺部感染的情况,以期为预防及减少术后肺部感染的发生提供参考依据。方法采用回顾性研究的方法,对某三级甲等综合性医院自2012年1月至2013年9月收治的头颈肿瘤气管切开术后患者532例的临床资料进行分析,按是否发生术后肺部感染,将其分为两组,即有肺部感染组（n=80）和无肺部感染组（n=452）,统计患者的性别、年龄、气套管留置时间等资料。结果有肺部感染组年龄22~87岁,平均（56.11±13.87）岁;气管套管留置时间3~58d,平均（15.71±8.87）d;无肺部感染组年龄3~88岁,平均（57.4±14.02）岁,气管套管留置时间2~43d,平均（11.35±5.28）d。与女性相比,男性更易并发肺部感染,差异有统计学意义（χ^2=5.340,P=0.013）。两组患者是否带管出院上的差异有统计学意义（z=-5.041,P=0.0001）。舌癌、颌骨及颊部肿瘤患者并发肺部感染的比例最高,分别为36.2%、18.8%和16.2%。结论头颈肿瘤患者术中选择性气切切开术并发肺部感染的比例较高,男性及舌癌、颌骨和颊部肿瘤患者术后需引起高度的重视,加强呼吸道护理以减少肺部并发症的发生。

Objective To understand the situation of complicated pulmonary infection after tracheostomy in surgery for head and neck oncology ,provide the reference for preventing and reduce the occurrence of postoperative pulmonary infection.Methods Clinical data of 532 cases were analyzed retrospectively,and the patients were divided into pulmonary infection group （n=80）,and non-pulmonary infection group（n=452）.The gender,age and time of catheter indwelling were analyzed.Results The age of pulmonary infec-tion group was 22~87 years,（56.11±13.87）years averagely;the indwelling time was 3~58 d,（15.71± 8.87）d averagely.The age of non-pulmonary infection group was 3~88 years,（57.4±14.02）years average-ly,the indwelling time was 2~43 d,（11.35±5.28）d averagely.Compared with female,the male were easy to be complicated with pulmonary infection（χ^2=5.340,P=0.013）.There was statistical significance of whether to discharge with catheter indwelling between two groups（z=-5.041,P=0.0001）.Patients who have tongue,j aw or cheek cancer suffered from pulmonary infection with highest percentage,which were 36.2%,18.8% and 16.2% respectively.Conclusion Patients with the head and neck cancer who received se-lective tracheotomy in surgery have higher incidence of complicated pulmonary infection.More attention should be given to the male and tongue,j aw or cheek cancer patients after surgery,to strengthen the respir-atory tract nursing,and to reduce the incidence of pulmonary infection.