乳腺癌术后肺部感染危险因素及其外周血细胞因子的变化

Risk factors of pulmonary infection after breast cancer operation and changes of cytokines in the peripheral blood

目的探讨乳腺癌术后肺部感染危险因素及其外周血细胞因子的变化。方法选择我院2016年4月~2020年4月乳腺癌改良根治术72例患者,按照术后是否出现肺部感染分为两组,其中感染组13例,未感染组59例,观察两组患者术后肺部感染的单因素、危险因素、血清肿瘤标志物水平、炎症因子水平,危险因素与其他之间的相关性。结果两组患者的年龄、是否合并糖尿病、TNM分期、术中出血量、术后引流量比较,差异无统计学意义(P>0.05);未感染组BMI、手术时间、置管时间均低于感染组,差异有统计学意义(P<0.05)。BMI、手术时间、置管时间均是肺部感染的主要危险因素(P<0.05)。未感染组患者CA153、CA125、TPS均低于感染组(P<0.05)。未感染组患者CRP、PCT、IL-6均低于感染组,未感染组血CTCs阳性表达率(8.47%)低于感染组的23.08%。乳腺癌术后肺部感染的发生与CA153、CA125、TPS、CRP、PCT、IL-6、CTCs存在正相关(P<0.05)。结论乳腺癌术后肺部感染主要是因BMI、手术时间、置管时间造成的,会直接影响患者的血清肿瘤标志物与炎症因子水平变化,为了保证术后患者情况,需要采取良好的术前措施,保证手术效果。

Objective To explore the risk factors of pulmonary infection after breast cancer operation and changes of cytokines in the peripheral blood.Methods From April 2016 to April 2020,a total of 72 patients who had received modified radical mastectomy in our hospital were selected and divided into two groups according to whether they had pulmonary infection after operation.Among them,there were 13 patients as pulmonary infection group and 59 patients as no pulmonary infection group.The univariate factors,the risk factors,the levels of serum tumor markers,the levels of inflammatory factors and the correlation between risk factors and other factors of postoperative pulmonary infection in the two groups of patients were observed.Results There were no differences in age,whether there was a complication with diabetes mellitus,TNM stage,intraoperative blood loss and postoperative drainage volume between the two groups of patients(P>0.05);the BMI,operation time and intubation time in the uninfected group were all lower than those in the infected group,with statistically significant differences(P<0.05).BMI,operation time and intubation time were all the main risk factors of pulmonary infection(P<0.05).The CA153,CA125 and TPS of the patients in the uninfected group were all lower than those in the infected group(P<0.05).The CRP,PCT and IL-6 of the patients in the uninfected group were all lower than those in the infected group,and the positive expression rate of CTCs in the uninfected group(8.47)was lower than the 23.08%in the infected group.The incidence of postoperative ipulmonary infection was possitively co helattd with CA153,CA125,TPS,CRP,PCT,IL-6 and CTCs(P<0.05).Conclusion Pulmonary infection after breast cancer operation is mainly caused by the factors of BMI,operation time and intubation time.It will directly affect the changes of the levels of serum tumor markers and of inflammatory factors in the patients.For the purpose of securing the patients'postoperative conditions,good preoperative measures should be taken to guarantee the operative effect.