喉癌手术后患者下呼吸道感染影响因素调查分析及护理对策

Investigation and analysis of influencing factors of lower respiratory tract infection in patients with laryngeal cancer after operation and nursing countermeasures

目的 探讨喉癌手术后患者下呼吸道感染影响因素及针对性护理对策。方法 对我院2017年7月至2018年6月耳鼻喉头颈外科收治的120例喉癌患者资料进行分析,调查患者术后下呼吸道感染影响因素并采取针对性护理措施。结果 17例患者术后发生下呼吸道感染,单因素分析显示,患者采用全喉切除术、术前气管切开、手术时间≥4h、合并糖尿病、住院时间>30d、临床分期≥Ⅲ期与下呼吸道感染有关(P<0.05),多因素logistic回归分析显示术前有气管切开、全喉切除术、手术时间≥4h、住院时间>30d、合并糖尿病以及疾病分期≥Ⅲ期是影响下呼吸道感染感染的独立危险因素(P<0.05)。结论 喉癌患者术后下呼吸道感染与手术方式、手术时间、住院时间、气管切开、合并糖尿病、疾病临床分期等因素有关,针对性给予全面护理干预措施,有利于降低术后感染概率。

Objective To discuss the influencing factors of lower respiratory tract infection in patients with laryngeal cancer after operation and and its nursing strategies. Methods To analyze the data of 120 patients with laryngeal cancer who were admitted to our hospital from July 2017 to June 2018. So, we can investigate the influencing factors of postoperative lower respiratory tract infection and took targeted nursing measures for this. Results There were 17 patients who had lower respiratory tract infection after operation. Univariate analysis showed that patients underwent total laryngectomy, preoperative tracheotomy, operative time ≥4 hours, complicated with diabetes, hospital stay > 30 days and clinical stage ≥Ⅲ phase were associated with lower respiratory tract infections( P < 0.05 ). Multivariate logistic regression analysis showed that preoperative tracheotomy, total laryngectomy, operative time ≥4 hours, hospital stay > 30 days, complicated with diabetes and disease stage ≥Ⅲ phase were independent risk factors for infection of lower respiratory tract infection( P < 0.05 ). Conclusion Since lower respiratory tract infection in patients with laryngeal cancer is related to surgical methods, operation time, hospitalization time, tracheotomy, diabetes mellitus, clinical stage of disease, etc., we should provide comprehensive nursing intervention measures to reduce the probability of postoperative infection.