非小细胞肺癌脑转移患者手术治疗医院感染相关因素分析

Analysis of hospital infection-related factors in surgical treatment of non-small cell lung cancer patients with brain metastases

目的探讨非小细胞肺癌脑转移患者手术治疗术后医院感染相关危险因素,为降低医院感染率提供依据。方法回顾性分析2010年1月-2014年6月收治的635例非小细胞肺癌脑转移患者临床资料,并分析患者术后感染相关因素与医院感染的相关性。结果 635例非小细胞肺癌脑转移患者发生医院感染80例,感染率为12.60%;感染部位主要以颅内、呼吸道、皮下、泌尿系统为主,其中最易感染部位为颅内感染,占45.00%,其次为呼吸道感染占26.25%、皮下感染占10.00%及泌尿系统占18.75%;后颅窝手术、手术时间、开放性颅脑损伤、拔管时间、置入植入物、脑脊液漏是非小细胞肺癌脑转移手术治疗患者发生医院感染的危险因素(P<0.05);logistic回归分析发现,后颅窝手术、开放性颅脑损伤、脑脊液漏等因素是发生医院感染的独立危险因素(P<0.05)。结论影响非小细胞肺癌脑转移手术治疗患者术后医院感染因素较多,应根据相关危险因素采取对应措施,预防与降低脑部术后感染率。

OBJECTIVE To investigate the risk factors associated with postoperative hospital infections in surgical treatment of non‐small cell lung cancer patients with brain metastasis ,so as to provide the basis for reducing hos‐pital infection rates .METHODS Totally 635 cases of non‐small cell lung cancer patients with brain metastases from Jan .2010 to Jun .2014 in our hospital were retrospectively analyzed .Postoperative infection and its related factors associated with nosocomial infections in non‐small cell lung cancer patients with brain metastases were retrospec‐tive analyzed .RESULTS A total of 80 cases of patients occurred nosocomial infections in 635 cases of non‐small cell lung cancer patients with brain metastases ,and the infection rate was 12 .60% ;the main sites of infection were brain ,respiratory tract ,skin and urinary system .Intracranial infection dominated the majority ,accounting for 45 .00% ,followed by respiratory tract infections accounting for 26 .25% ,subcutaneous infections accounting for 10 .00% ,and urinary system accounting for 18 .75% .Posterior fossa surgery ,operative time ,open craniocerebral injury ,extubation time ,implant placement ,cerebrospinal fluid leakage were risk factors for nosocomial infections in non‐small cell lung cancer patients with brain metastases （P〈0 .05） .The logistic regression analysis found that cranial fossa surgery ,open craniocerebral injury and cerebrospinal fluid leakage were independent risk factors for nosocomial infections （P〈0 .05） .CONCLUSION Factors affecting infections of non‐small cell lung cancer patients with brain metastasis after surgery are various .Corresponding measures should be taken in accordance with the relevant risk factors to prevent postoperative infections of the brain and to reduce infection rates .