食管癌术后肺部感染危险因素分析

发布时间：2018-02-28 08:21

  本文关键词： 食管癌术后 肺部感染 危险因素　出处：《新乡医学院》2015年硕士论文　论文类型：学位论文

【摘要】：背景食管癌是我国最常见的恶性肿瘤之一,其临床治疗效果相当有限,5年生存率低于15%,而早期诊断则是提高食管癌生存率的最佳方法；对于已经明确诊断的食管癌患者,手术治疗则是其中最有效的治疗方法。但由于患者自身体质因素以及合并病症等影响,食管癌术后容易出现一系列并发症,其中肺部感染发生率较高,影响患者术后恢复,增加术后死亡率。目的通过分析食管癌术后肺部感染产生的危险因素,探索预防与治疗术后肺部感染的有效途径,降低食管癌术后肺部感染的发生率。方法收集新乡医学院第一附属医院胸外科本组2012年3月到2013年12月间无合并其它感染的食管癌(均为鳞癌)病例187例,均在本院行食管癌根治术治疗。采集病患相关临床资料,获取年龄、合并既往病史(慢性阻塞性肺疾病、高血压病、糖尿病、冠心病)、吸烟史、手术方式、术中通气方式、手术时间及肿瘤分期等基本资料；对患者进行术后临床观察,根据是否发生肺部感染,将187例患者分为两组,一组为术后发生肺部感染的患者,另一组为术后无肺部感染发生的患者。应用描述性统计分析方法描述患者基本资料；采用卡方检验进行计数资料两变量分析或t检验进行计量资料两变量分析,比较两组病患基本资料；采用logistic回归分析法筛选影响食管癌术后肺部感染产生的相关危险因素。结果通过统计分析对比,肺部感染组与非肺部感染组患者年龄、合并慢性阻塞性肺疾病、合并糖尿病、吸烟史、手术时间及肿瘤分期具有统计学意义(P0.05)。而术中通气方式、手术方式、合并高血压病以及合并冠心病病史并没有产生显著性差异(P0.05)。结论本研究发现,病患年龄大、合并COPD、合并糖尿病、长期吸烟史、手术时间超过3小时及肿瘤分期处于Ⅲ期±Ⅳ期均是发生术后肺部感染的危险因素。
[Abstract]:Background esophageal cancer is one of the most common malignant tumors in China. Its clinical therapeutic effect is very limited, the 5-year survival rate is less than 15%, and early diagnosis is the best way to improve the survival rate of esophageal cancer. Surgical treatment is one of the most effective treatment methods. However, due to the influence of the patient's own physical condition and complicated diseases, a series of complications are likely to occur after the operation of esophageal cancer, in which the incidence of pulmonary infection is high, which affects the patient's postoperative recovery. Objective to explore the effective ways to prevent and treat postoperative pulmonary infection by analyzing the risk factors of postoperative pulmonary infection of esophageal carcinoma. Methods A total of 187 cases of esophageal cancer (all squamous cell carcinomas) with no other infection between March 2012 and December 2013 were collected from chest surgery department, the first affiliated hospital of Xinxiang Medical College, to reduce the incidence of postoperative pulmonary infection. All patients were treated with radical resection of esophageal cancer in our hospital. Clinical data were collected, age was obtained, and previous history (chronic obstructive pulmonary disease, hypertension, diabetes, coronary heart disease, smoking history, operative method, intraoperative ventilation) was obtained. After surgery, 187 patients were divided into two groups according to whether or not they had pulmonary infection. The first group was patients with postoperative pulmonary infection. The other group was the patients who had no pulmonary infection after operation. The basic data of the patients were described by descriptive statistical analysis, and the counting data were analyzed by chi-square test, or the data were analyzed by t-test. The basic data of the two groups were compared, and the risk factors of pulmonary infection after esophageal cancer operation were screened by logistic regression analysis. Results by statistical analysis, the age of patients with pulmonary infection was compared with that of non-pulmonary infection. Chronic obstructive pulmonary disease (COPD), diabetes mellitus, smoking history, operation time and tumor staging were statistically significant (P 0.05). There was no significant difference in the history of hypertension and coronary heart disease (P 0.05). Conclusion this study found that patients with older age, complicated with COPDs, complicated with diabetes, and had a long history of smoking. Postoperative pulmonary infection was associated with postoperative pulmonary infection after operation for more than 3 hours and stage 鈪，

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