胃癌患者腹腔镜下胃大部切除术后肺部感染的影响因素

Influencing factors of pulmonary infection in patients with gastric cancer after laparoscopic subtotal gastrectomy

目的探究胃癌患者腹腔镜下胃大部切除术后肺部感染的影响因素。方法选取2018年10月-2019年12月新疆医科大学第一附属医院收治的330例行腹腔镜下胃大部切除术的胃癌患者,对患者的术后感染情况进行判定,按照是否发生术后肺部感染分为感染组(n=66)和非感染组(n=264)。对两组临床资料进行回顾性分析,比较两组术后胃癌组织中金属蛋白酶-2(MMP-2)、金属蛋白酶组织抑制剂-1(TIMP-1)的表达情况并采用Logistic多因素回归分析探究术后肺部感染的影响因素。结果感染组胃癌组织MMP-2、TIMP-1表达水平均高于非感染组(P<0.05)。多因素Logistic回归分析结果显示,年龄大、吸烟、术前使用抗菌药物、术后卧床时间长及胃癌组织中MMP-2、TIMP-1水平高均为胃癌患者腹腔镜下胃大部切除术后肺部感染的独立危险因素(OR=10.644;4.674;3.543;2.724;2.754;2.683,P<0.05);低BMI为其保护因素(OR=0.450,P<0.05)。结论影响胃癌患者发生术后肺部感染的独立危险因素有年龄大、吸烟、糖尿病、消化性溃疡、术前使用抗菌药物、术后卧床时间长及胃癌组织中MMP-2、TIMP-1的高表达。

OBJECTIVE To explore the influencing factors of pulmonary infection in patients with gastric cancer after laparoscopic subtotal gastrectomy. METHODS A total of 330 patients with gastric cancer who underwent laparoscopic subtotal gastrectomy in the first affiliated hospital of Xinjiang medical university from October 2018 to December 2019 were selected and the postoperative infection status of the patients was determined. According to the occurrence of postoperative pulmonary infection, the patients were divided into the infection group(n=66) and the non-infection group(n=264). The clinical data of the two groups were retrospectively analyzed, and the expressions of metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-1(TIMP-1) in gastric cancer tissues of the two groups after operation were compared and Logistic multivariate regression analysis was used to explore the influencing factors of postoperative pulmonary infection. RESULTS The expression levels of matrix metalloproteinase-2(MMP-2) and tissue inhibitorof metalloproteinase-1(TIMP-1) in gastric cancer tissues of the infection group were significantly higher than those of the non-infection group(P<0.05). The results of multivariate Logistic regression analysis showed that high age, smoking, preoperative use of antibiotics, long time in bed postoperative, and high level of MMP-2 and TIMP-1 in gastric cancer tissues were all independent risk factors of pulmonary infection after laparoscopic subtotal gastrectomy for gastric cancer(OR=10.644;4.674;4.899;2.852;3.543;2.724;2.754;2.683, P<0.05);low BMI was a protective factor(OR=0.450, P<0.05). CONCLUSION The independent risk factors affecting postoperative pulmonary infection in gastric cancer patients included high age, smoking, diabetes, peptic ulcer, preoperative use of antibiotic, long postoperative bed time, and high levels expression of MMP-2 and TIMP-1 in gastric cancer tissues.