口腔鳞状细胞癌患者术后局部感染的危险因素

Risk factors of postoperative local infection in patients with oral squamous cell carcinoma

目的探讨口腔鳞状细胞癌患者术后局部感染的危险因素。方法收集275例口腔鳞状细胞癌患者的临床资料,统一制表并登记,统计病原学分析结果及一般资料,分析院内感染的危险因素。结果90例口腔鳞状细胞癌术后局部感染患者中共分离出107株病原菌,主要为革兰阳性菌(59.81%),其中金黄色葡萄球菌(27.10%)较为常见;其次为革兰阴性菌(40.19%),其中铜绿假单胞菌(18.69%)较为常见。单因素分析结果显示,不同年龄、体重指数(BMI)、肿瘤部位、肿瘤直径、合并糖尿病情况、合并慢性阻塞性肺疾病情况、合并症数量、缺损修复方案、手术时间和输血情况的口腔鳞状细胞癌患者术后局部感染情况比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥60岁、BMI﹤20 kg/m^(2)、合并糖尿病、合并症数量﹥2个、缺损修复区域/游离皮瓣、手术时间﹥6 h均是口腔鳞状细胞癌患者术后局部感染的独立危险因素(P﹤0.05)。结论口腔鳞状细胞癌患者术后局部感染的危险因素较多,可通过充分术前评估尽可能地减少危险因素对口腔鳞状细胞癌患者造成的影响。

Objective To explore the risk factors of local infection in patients with oral squamous cell carcinoma(OSCC)after operation.Method A total of 275 patients with OSCC were selected,the clinical data was registered by unified tabulation,the results of etiological analysis and general data were counted,and the risk factors leading to nosocomial infection were analyzed.Result A total of 107 strains of pathogenic bacteria were isolated from 90 patients with local infection after operation of OSCC;the primary bacteria was gram-positive bacteria(59.81%),in which the staphylococcus aureus(27.10%)was more common,and the secondary bacteria was Gram-negative bacteria(40.19%),in which the pseudomonas aeruginosa(18.69%)was more common.Univariate analysis showed that there were significant differences in postoperative local infection among patients with OSCC in different ages,body mass index(BMI),tumor location,tumor diameter,concomitant diabetes mellitus and chronic obstructive pulmonary disease,number of complications,defect repair plan,operation time and blood transfusion(P<0.05).Multivariate analysis showed that age≥60 years old,BMI<20 kg/m^(2),concomitant diabetes mellitus,number of complications>2,defect repair area/free flap and operation time>6 h were all independent risk factors for local infection in patients with OSCC(P<0.05).Conclusion There are many risk factors for local infection in patients with OSCC after operation,and the influence of risk factors on patients with OSCC can be reduced as much as possible through full preoperative evaluation.