甲状腺乳头状癌患者术后医院感染危险因素分析

Risk factors for postoperative nosocomial infections in patients with papillary thyroid cancer

目的研究甲状腺乳头状癌患者术后发生医院感染危险因素,为提高手术治疗效果,降低感染率提供参考依据。方法选取2014年1-12月医院诊治的120例甲状腺乳头状癌患者临床资料,入选患者均行手术切除治疗,采用自拟问卷调查表对患者临床资料进行统计,包括:姓名、年龄、血糖情况、留置引流管、引流天数等,分析甲状腺乳头状癌患者术后医院感染的危险因素,采用SPSS 18.0软件对数据进行分析。结果 120例甲状腺乳头癌患者中15例发生医院感染,感染率为12.5%;感染部位分别为呼吸道、泌尿系统、手术切口及其他,分别占46.67%、33.33%、13.33%及6.67%;甲状腺乳头状癌患者术后发生医院感染与血压、预防性使用抗菌药物等无关;多因素logistic分析结果显示,年龄≥60岁、引流天数>3d、有留置橡胶引流管、血糖≥6.2mmol/L等均为甲状腺乳头状癌患者术后发生医院感染患者的危险因素(P<0.05)。结论甲状腺乳头状癌患者术后发生医院感染危险因素相对较多,应该根据危险因素提出针对性的解决措施,降低术后感染率。

OBJECTIVE To explore the risk factors for postoperative nosocomial infections in patients with papillary thyroid cancer so as to improve the curative effect of surgical procedures,reduce the infection rate,and provide guidance.METHODS The clinical data were collected from 120 patients with papillary thyroid cancer who were treated in hospitals from Jan 2014 to Dec 2014,all of the enrolled patients underwent surgical resection,and the self-prepared questionnaires were employed to investigate the clinical data of the patients,including the name,age,blood glucose level,drainage tube indwelling,and duration of drainage.The risk factors for the postoperative nosocomial infections in the patients with papillary thyroid cancer were observed,and the statistical analysis of data was performed with the use of SPSS 18.0software.RESULTS Of the 120 patients with papillary thyroid cancer,15 had postoperative nosocomial infections,with the infection rate of 12.5%.Among the patients with the postoperative nosocomial infections,46.47% had respiratory tract infections,33.33% had urinary tract infections,13.33% had surgical incision infections,and 6.67% had other sites of infections.The prevalence of the postoperative nosocomial infections in the papillary thyroid cancer patients was not associated with the blood pressure or prophylactic use of antibiotics.The multivariate logistic regression analysis indicated that the risk factors for the postoperative nosocomial infections in the patients with papillary thyroid cancer included the no less than 60 years of age,duration of drainage more than 3days,rubber drainage tube indwelling,and blood glucose level no less than 6.2mmol/L（P〈0.05）.CONCLUSION There are a variety of risk factors for the postoperative nosocomial infections in the patients with papillary thyroid cancer.It is necessary to put forward the targeted intervention measures according to the risk factors so as to reduce the incidence of the postoperative nosocomial infections.