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喉癌术后手术部位感染情况调查及危险因素分析
谢迁1,曹彬2,魏永祥1*,王宁宇1,刘锦峰1,张娟1
0
(1. 首都医科大学附属北京朝阳医院耳鼻咽喉-头颈外科,北京 100020; 2. 首都医科大学附属北京朝阳医院感染与临床微生物科,北京 100020)
摘要:
目的探讨喉癌术后手术部位感染(SSI)及其发生的危险因素。方法回顾性调查我院2006年1月至2010年12月96例喉癌手术患者的临床资料,应用SPSS 13.0软件分析其发病相关因素。结果96例喉癌患者发生SSI 15例,感染率为15.6%;单因素分析表明:临床分期、手术时间、术式及术前气管切开是SSI发生的危险因素(P<0.05);Logistic逐步回归分析表明:临床分期(OR=0.273)和全喉术式(OR=8.085)是喉癌术后SSI的独立危险因素。结论对临床分期较晚、手术范围较大的患者,应注意提高术中手术技巧、缩短手术时间、正确及时处理术后感染,以减少SSI的发生,降低咽瘘的发生率。
关键词:  喉肿瘤  喉切除术  外科伤口感染  危险因素
DOI:10.3724/SP.J.1008.2011.0521
投稿时间:2011-02-13修订日期:2011-05-10
基金项目:
Study on surgical site infection following laryngectomy and its risk factors
XIE Qian1,CAO Bin2,WEI Yong-xiang1*,WANG Ning-yu1,LIU Jin-feng1,ZHANG Juan1
(1. Department of Otolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China; 2. Department of Infectious Diseases and Clinical Microbiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China)
Abstract:
ObjectiveTo investigate the infection at surgical sites of laryngectomy and the related risk factors.MethodsWe retrospectively analyzed the clinical data of 96 laryngeal cancer patients, who received laryngectomy in our hospital between Jan. 2006 and Dec. 2010. SPSS 13.0 software was used to analyze the risk factors.ResultsWe found that 15 patients (15.6%) had infection in the surgical sites. ANOVA analysis indicated that the clinical stage, operation time, surgical procedures and preoperative tracheostomy were the risk factors for surgical site infection (P<0.05). Logistic stepwise regression analysis indicated that the clinical stage(OR=0.273) and surgical procedures(OR=8.085) were the independent risk factors.ConclusionImproving the surgical techniques, shortening operation time, and timely and correct management of infection can reduce surgical site infection and pharyngo-cutaneous fistula in laryngeal cancer patients at advanced clinical stages and with extensive operation involvement.
Key words:  laryngeal neoplasms  laryngectomy  surgical wound infection  risk factors