喉癌术后感染相关因素及与局部肿瘤复发的相关性分析

Analysis on the factors of the postoperative infection in laryngeal cancer and its relationship with local tumor recurrence

目的分析喉癌术后感染相关因素及与局部肿瘤复发的相关性。方法回顾性分析于本院行手术治疗的160例喉癌患者的临床资料,记录术后感染的部位及病原菌种类;采用Logistic回归方程计算喉癌术后感染高危因素。统计喉癌术后感染者的局部复发率,分析喉癌术后感染与局部肿瘤复发的相关性。结果 160例喉癌手术患者中发生感染共30例,感染率为18.75%;术后感染部位主要是切口,其次分别为呼吸道和咽部等。30例术后感染者中共分离出27株病原菌,其中革兰阳性菌12株(44.44%),革兰阴性菌15株(55.56%)。多因素分析显示,手术时间、临床分期和全喉切除术是导致喉癌术后感染的主要危险因素(P均<0.05)。术后随访6个月,160例患者中有18例局部复发,复发率为11.25%;其中术后感染者局部复发8例,复发率26.67%(8/30);无感染者术后局部复发率为7.69%(10/130),两组相比差异具有统计学意义(χ2=12.659、P=0.000)。结论导致喉癌术后感染的主要危险因素为手术时间、临床分期和手术类型;术后感染者局部肿瘤复发率更高。

Objective To analyze the factors of the postoperative infection in laryngeal cancer and its relationship with the local tumor recurrence. Methods The clinical data of 160 cases of laryngeal carcinoma patients treated in our hosptial were analyzed, retrospectively, while the location and pathogens occurred postoperative infection were analyzed. The risk factors were calculated by Logistic regression equation. Local recurrence rate of postoperative infection was laryngeal statistics, correlation of laryngeal postoperative infection and local recurrence were analyzed, respectively. Results Among the 160 laryngeal cancer patients with operation, there were 30 cases with infection, with the infection rate of 18.75%. The main postoperative incision site infection was incision, and then were respiratory system, pharynx. There were 27 strains of pathogenic bacteria were isolated from 30 cases with postoperative infection, included 12 （44.44%） strains of Gram positive, 15 （55.56%） strains of Gram negative. The multivariate analysis showed that the operation time, clinical stage and total laryngectomy were the main risk factors of postoperative infection cause laryngeal cancer （P all〈0.05）. Patients were followed up for 6 months, among 160 cases, there were 18 cases with local recurrence, with the recurrence rate of 11.25%. Local recurrence in patients with postoperative infection in 8 cases, with the recurrence rate of 26.67%（8/30）;no infection of patients with postoperative local, with the recurrence rate of 7.69%（10/130）, with significant differences （χ^2=12.659, P=0.000）. Conclusions The major risk factors caused laryngeal cancer postoperative infection were operation time, clinical staging and operation type. The recurrence rate of patients with postoperative infection tumor was higher.