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中国癌症防治杂志 ›› 2020, Vol. 12 ›› Issue (1): 95-99.doi: 10.3969/j.issn.1674-5671.2020.01.17

• 临床应用 • 上一篇    下一篇

肺癌患者术后并发肺部感染的危险因素分析

  

  1. 岛市胶州中心医院呼吸内一科;青岛市第八人民医院肿瘤科
  • 出版日期:2020-02-25 发布日期:2020-03-10
  • 通讯作者: 高积绪 E-mail:gjxqdsd@163.com

  Analysis of risk factors of postoperative pulmonary infection in patients with lung cancer

  • Online:2020-02-25 Published:2020-03-10

摘要: 目的 探讨肺癌患者术后并发肺部感染(postoperative pulmonary infection in patients with lung cancer,PPILC)的危险因素。方法 选取2011年3月至2018年2月手术治疗的851例肺癌患者为研究对象。鉴定病原菌并采用多因素Logistic回归分析影响PPILC的危险因素。 结果 60例肺癌患者发生术后并发肺部感染,共分离出86株病原菌,其中革兰氏阴性菌占60.5%,以铜绿假单胞菌和肺炎克雷伯菌为主;革兰氏阳性菌占33.7%,以金黄色葡萄球菌和表皮葡萄球菌为主;真菌占5.8%。多因素Logistic回归分析显示,TNM分期、吸烟、年龄、合并糖尿病、慢性阻塞性肺疾病、侵入性操作、手术时间、术中出血量、机械通气时间、术后胸腔引流总量、术后血红蛋白和血清白蛋白水平、胸腔引流时间、预防性使用抗菌药物和住院时间为PPILC的影响因素(P<0.05)。结论 年龄、吸烟、合并糖尿病、慢性阻塞性肺疾病、TNM分期等可影响PPILC的发生,临床上应加强关注合并以上危险因素患者术后肺部感染的防治。

关键词: 肺癌, 肺部感染, 影响因素

Abstract: Objective  To explore the risk factors of postoperative pulmonary infection in patients with lung cancer(PPILC). Methods A total of 851 lung cancer patients who underwent surgical treatment from March 2011 to February 2018 were selected as the research subjects. The risk factors of PPILC were analyzed by multivariate logistic regression analysis after isolation and identification of pathogenic bacteria. Results There were 60 patients with postoperative pulmonary infection,and 86 pathogenic bacteria were isolated,of which Gram-negative bacteria accounted for 60.5%,mainly Pseudomonas aeruginosa and Klebsiella pneumonia; Gram-positive bacteria accounted for 33.7%,mainly Staphylococcus aureus and Staphylococcus epidermidis; fungus accounted for 5.8%. Multivariate logistic regression analysis showed that the influencing factors of PPILC included TNM stage,smoking,age,merged diabetes,chronic obstructive pulmonary disease,invasive operation,operation time,intraoperative bleeding volume,mechanical ventilation time,total amount of postoperative thoracic drainage,postoperative hemoglobin level,postoperative serum albumin level,duration of thoracic drainage,prophylactic use of antibiotics and length of stay(P<0.05). Conclusions Age,smoking,concomitant diabetes,chronic obstructive pulmonary disease,and TNM staging can affect the occurrence of PPILC. In clinical practice,more attention should be paid to the prevention and treatment of postoperative pulmonary infection in patients with the above risk factors. 

Key words: Lung cancer, Pulmonary infection, Influencing factors

中图分类号: 

  • R734.2