食管癌术后感染性并发症的影响因素分析

Risk factors of the infectious complications after esophagectomy in patients with esophageal cancer

目的:探讨食管癌术后感染性并发症发生的主要术前危险因素。方法:收集2019年3月-2020年12月北京大学肿瘤医院食管鳞癌100例为研究对象,于术前1 d进行营养风险筛查2002、PG-SGA评估、人体成分、握力等评估,并收集与术后感染并发症相关的一般信息如性别、年龄、BMI、合并疾病、生化检验等资料。根据Clavien-Dindo分类(CDC)对术后感染性并发症发病率进行分类,分为感染性并发症和无感染性并发症两组。单因素分析采用卡方检验或t检验,多因素采用Logistic回归分析得出危险因素。结果:100例食管癌病人术后发生感染性22例,发生率22%。单因素分析结果发现,PG-SGA、CRP、NLR,预后营养指数,细胞外水分/总水分、总体水分/去脂体质量,相位角与术后感染有关,差异有统计学意义(P <0.05);多因素分析发现,预后营养指数和总体水分/去脂体质量与术后感染性并发症的独立影响因素,差异有统计学意义(P <0.05)。结论:术前总体水分/去脂体质量、预后营养指数为食管癌术后感染性并发症的影响因素,较高的总体水分/去脂体质量和较低的预后营养指数预示较差的预后。

Objective: To investigate the major risk factors of postoperative infection in the patients with esophageal cancer. Methods: 100 patients with esophageal cancer who hospitalized in the Beijing Cancer Hospital from march 2019 to december 2020 were enrolled in this study. The general information of the patients, including gender, age,comorbidities and body mass index(BMI), were collected on admission days. The patients’ nutritional status, body composition, grip strength and blood biochemistry were evaluated before surgical treatments. The postoperative complications were classified according to the Clavin-Dindo Classification(CDC). Statistical analyses were conducted with SPSS software(version 21.0). Results: The prevalence of postoperative infectious complications was 22% in the patients with esophageal cancer. Univariate analysis showed that 7 variables, including PG-SGA, CRP, NLR, prognostic nutritional index, extracellular water/total body water, total body water/fat-free mass, phase angle, were closely related to presence of the infectious complications(P < 0.05). Multivariate Logistic regression analysis revealed that low prognostic nutritional index and total body water/fat-free mass were associated with postoperative infectious complications in the patients. Conclusions: Preoperative total body water/fat free mass and prognostic nutritional index might be considered as risk factors for the presence of postoperative infectious complications in patients with esophageal cancer.