摘要
目的探讨口腔颌面部恶性肿瘤患者术后感染的危险因素。方法收集接受手术治疗的89例口腔颌面部恶性肿瘤患者的临床资料,分析术后感染患者的感染部位及病原菌分布,比较不同临床特征口腔颌面部恶性肿瘤患者的术后感染情况,采用Logistic回归模型分析口腔颌面部恶性肿瘤患者术后感染的危险因素。结果口腔颌面部恶性肿瘤患者术后感染最常见的部位是手术切口(45.16%)和呼吸道(38.71%),常见的感染病原菌为化脓性链球菌(16.13%)、表皮葡萄球菌(9.68%)、铜绿假单胞菌(9.68%)和肺炎克雷伯菌(9.68%)。单因素分析结果显示,年龄≥60岁、手术时间≥4 h、术后血清白蛋白﹤35 g/L、合并糖尿病的口腔颌面部恶性肿瘤患者术后感染的发生率分别高于年龄﹤60岁、手术时间﹤4 h、术后血清白蛋白≥35 g/L、未合并糖尿病的患者,差异均有统计学意义(P﹤0.05)。Logistic回归分析结果显示,手术时间≥4 h、术后血清白蛋白﹤35 g/L及合并糖尿病均是口腔颌面部恶性肿瘤患者术后感染的独立危险因素(P﹤0.05)。结论口腔颌面部恶性肿瘤患者术后发生感染的风险较大,常见的感染部位是手术切口和呼吸道,最常见的感染病原菌为化脓性链球菌,需要特别关注手术时间长、术后血清白蛋白低及合并糖尿病的患者,做好预防感染的措施。
Objective To explore the risk factors of postoperative infection of oral and maxillofacial malignant tumors.Method The clinical data of 89 patients with oral and maxillofacial malignant tumors were retrospectively analyzed.The infection site and distribution of pathogenic bacteria were analyzed,and the postoperative infections among patients with differing clinical characteristics were compared,besides,Logistic regression analysis was performed to determine the risk factors of postoperative infection in patients with oral and maxillofacial malignant tumors.Result The most common sites of postoperative infection were surgical incision(45.16%)and respiratory tract(38.71%);and the dominant pathogenic bacteria were streptococcus pyogenes(16.13%),staphylococcus epidermidis(9.68%),pseudomonas aeruginosa(9.68%)and Klebsiella pneumoniae(9.68%).Univariate analysis showed that,age≥60,operative time≥4 h,postoperative serum albumin<35 g/L,and comorbidity of diabetes mellitus were associated with significantly increased postoperative infection compared to those with age<60,operative time<4 h,postoperative serum albumin≥35 g/L,and no combined diabetes mellitus(P<0.05).Logistic analysis revealed that,operative time≥4 h,postoperative serum albumin<35 g/L and diabetes mellitus were independent risk factors for the postoperative infection of patients with oral and maxillofacial malignant tumors(P<0.05).Conclusion The risk of infection after surgery in patients with oral and maxillofacial malignant tumor is relatively high,with the most common infection sites being surgical incision and respiratory tract,and the infection is often caused by streptococcus pyogenes.Special attention should be paid to patients with prolonged operative time,low postoperative serum albumin,and comorbidity of diabetes mellitus,and interventions should be taken to prevent infections.
作者
孙娜娜
王陈保
钱鑫
SUN Nana;WANG Chenbao;QIAN Xin(Department of Stomatology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)
出处
《癌症进展》
2020年第10期1051-1053,1060,共4页
Oncology Progress
关键词
口腔颌面部
恶性肿瘤
感染
危险因素
oral and maxillofacial region
malignant tumor
infection
risk factor
