口腔颌面部多间隙感染患者院内发生不良结局的相关危险因素分析

Related risk factors for adverse outcome in patients with nosocomial infection in multiple spaces of oral and maxillofacial region

目的探讨口腔颌面部多间隙感染患者院内出现不良结局的相关危险因素。方法回顾性分析2005年1月至2015年1月我院收治的122例口腔颌面部多间隙感染患者的临床资料,对感染患者的病因分类及院内发生并发症的构成比进行收集统计,并对发生院内不良结局(住院时间延长及并发症)的相关危险因素进行单因素χ2检验、多元线性回归以及多因素Logistic回归分析。结果 122例患者中有48例出现并发症,发生率为39.3%,122例患者以牙源性感染为主(70.5%),其发生院内并发症的构成比为87.5%(42/48),单因素分析中感染患者住院时间与合并系统性疾病、症状发作到入院时间、累及间隙数量、入院时血糖浓度、入院时白细胞计数及中性粒细胞百分比有关(P<0.05),而并发症与年龄、合并系统性疾病、累及间隙数量、入院时血糖浓度、入院时白细胞计数及中性粒细胞百分比有关(P<0.05);多元线性回归分析提示:合并全身系统性疾病、累及间隙数量、入院时血糖水平与住院时间呈正相关(P<0.05),多因素Logistic回归分析显示:年龄(OR=1.580)、合并系统性疾病(OR=1.814)、累及间隙数量(OR=2.024)、入院时血糖浓度(OR=1.137)、入院时白细胞计数(OR=1.532)是口腔颌面部多间隙感染患者出现院内并发症的独立预测因素。结论口腔颌面部多间隙感染患者合并全身系统性疾病、累及间隙数量、入院时血糖浓度、入院时白细胞计数与治疗转归密切相关,临床应当针对这些高危因素加强干预治疗措施,积极扭转不良转归趋势以改善患者的预后。

Objective To explore the related risk factors for adverse outcome in patients with nosocomial in-fection in multiple spaces of oral and maxillofacial region. Methods A retrospective analysis of the clinical data of 122 patients with infection in multiple spaces of oral and maxillofacial region in our hospital from January 2005 to Jan-uary 2015 was performed. The constituent ratios of causes of infection and nosocomial complications were investigat-ed. Single factors chi-square test, multiple linear regression analysis and the multi-factor logistic regression analysis were performed for the related risk factors of the adverse outcomes （extended length of hospital stay and complica-tions）. Results Among the 122 patients, 48 were found with complications, with the incidence of 39.3%. Most of （70.5%） of the 122 patients were tooth source infection, and the constituent ratio of the nosocomial complications was 87.5%（42/48）. Single factor analysis showed that length of hospital stay was related to the combination of systemic disease, duration from symptom onset to admission, the number of interval involved, blood glucose level at admission, leukocyte count and neutrophil percentage at admission （P〈0.05）. The complications were related to the age, the sys-temic diseases and complications, the number of interval involved, blood glucose level at admission, leukocyte count and neutrophil percentage at admission （P〈0.05）. Multiple linear regression analysis showed that systemic disease, the number of interval involved, blood glucose level at admission and length of hospital stay were positively correlated （P〈0.05）. The multi-factor logistic regression analysis showed that age （OR=1.580）, systemic diseases （OR=1.814）, the number of interval involved （OR=2.024）, blood glucose level at admission （OR=1.137）, leukocyte count at admis-sion （OR=1.532） were the independent predictors of complications for patients with nosocomial infection in multiple spaces of oral and maxillofacial region. Conclusion For patients with nosocomial infection in multiple spaces of oral and maxillofacial region, the systemic diseases, the number of interval involved, blood glucose level at admission, leu-cocyte count at admission are closely related to treatment outcome. Clinically, we should strengthen intervention mea-sures according to the risk factors and control adverse outcomes in order to improve the prognosis of patients.