[1]呼爱鲜.肺癌患者肺切除术后肺部感染危险因素分析[J].新乡医学院学报,2022,39(2):160-164.[doi:10.7683/xxyxyxb.2022.02.012]
　HU Aixian.Risk factors for pulmonary infection in patients with lung cancer after pulmonary resection[J].Journal of Xinxiang Medical University,2022,39(2):160-164.[doi:10.7683/xxyxyxb.2022.02.012]
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肺癌患者肺切除术后肺部感染危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年2
页码:
160-164
栏目:
临床研究
出版日期:
2022-02-05

文章信息/Info

Title:
Risk factors for pulmonary infection in patients with lung cancer after pulmonary resection
作者:
呼爱鲜
（郑州大学第一附属医院医学装备部，河南　郑州　450052）
Author(s):
HU Aixian
（Department of Medical Equipment,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China）
关键词:
肺癌; 肺部感染; 危险因素
Keywords:
lung cancer; pulmonary infection; risk factor
分类号:
R734.2
DOI:
10.7683/xxyxyxb.2022.02.012
文献标志码:
A
摘要:
目的　探讨肺癌患者肺切除术后肺部感染的发生情况及危险因素，以期为肺癌患者术后并发肺部感染的预防提供依据。方法　选择2013年4月至2020年3月郑州大学第一附属医院收治的730例肺癌患者为研究对象。收集患者的一般临床资料，包括：性别、年龄、民族、婚姻状况、居住地、吸烟史、饮酒史、糖尿病史、高血压病史、肺部相关疾病史、第1秒用力呼气量占用力肺活量的比例（FEV1/FVC）；围手术期临床资料，包括：手术方式、手术时间、手术部位、术中出血量、术后胸腔引流总量、机械通气时间、胸腔引流时间、住院时间。应用全自动微生物鉴别系统检测患者术后3 d并发肺部感染肺癌患者痰液中的病原菌种类和数量。结果　730例肺癌患者中，术后出现肺部感染82例（感染组），未出现肺部感染648例（对照组）。感染组82例患者中，混合病原菌感染的患者64例（78.05%），单纯病原菌感染的患者18例（21.95%）；从感染组患者痰液中共培养出136株病原菌株，其中革兰阴性菌71株（52.20%），主要以溶血不动杆菌和肺炎克雷伯菌为主；革兰阳性菌55株（40.44%），主要以溶血葡萄球菌和金黄色葡萄球菌为主；真菌10株（7.35%）。单因素分析结果显示，年龄、吸烟史、糖尿病史、肺部相关疾病史、手术方式、手术时间、术中出血量、术后胸腔引流总量、机械通气时间、胸腔引流时间、住院时间与肺癌患者术后并发肺部感染有关（P<0.05）；性别、民族、婚姻状况、居住地、高血压病史、FEV1/FVC、手术部位与肺癌患者术后并发肺部感染无关（P>0.05）。Logistic回归分析结果显示，年龄≥60岁、有吸烟史、有糖尿病史、有肺部相关疾病史、手术方式（开胸）、手术时间≥3 h、术中出血量≥200 mL、术后胸腔引流总量≥600 mL、机械通气时间≥12 h、胸腔引流时间≥5 d、住院时间≥20 d是肺癌患者术后并发肺部感染的独立危险因素（P<0.05）。结论　肺癌患者术后肺部感染的发生率较高，年龄≥60岁、有吸烟史、有糖尿病史、有肺部相关疾病史、手术方式（开胸）、手术时间≥3 h、术中出血量≥200 mL、术后胸腔引流总量≥600 mL、机械通气时间≥12 h、胸腔引流时间≥5 d、住院时间≥20 d是肺癌患者术后并发肺部感染的独立危险因素。
Abstract:
Objective　To investigate the incidence and risk factors of pulmonary infection of patients with lung cancer after pulmonary resection,in order to provide the evidence for the prevention of postoperative pulmonary infection of patients with lung cancer.Methods　A total of 730 patients with lung cancer admitted to the First Affiliated Hospital of Zhengzhou University from April 2013 to March 2020 were selected as the research subjects.The general clinical data of the patients were collected,including gender,age,ethnicity,marital status,place of residence,smoking history,drinking history,diabetes history,hypertension history,history of lung-related diseases,forced expiratory volume in one second/forced vital capacity(FEV1/FVC)；the perioperative clinical data were collected,including operation method,operation time,surgical site,intraoperative blood loss,total postoperative thoracic drainage,mechanical ventilation time,thoracic drainage time,hospitalization time.The species and quantity of pathogenic bacteria in the sputum of patients with lung cancer complicated with pulmonary infection were detected by the automatic microbiological identification system at 3 days after operation.Results　Among the 730 patients with lung cancer,82 patients had pulmonary infection after operation (infection group),and 648 patients did not have pulmonary infection (control group).Among the 82 patients in the infection group,64 (78.05%) patients were infected with mixed pathogens,and 18 (21.95%) patients were infected with pure pathogens;a total of 136 pathogenic strains were cultured from the sputum of patients in the infection group,including 71 (52.20%) strains gram-negative bacteria,mainly included Acinetobacter hemolyticus and Klebsiella pneumoniae;55 (40.44%) strains gram-positive bacteria,mainly included Staphylococcus hemolyticus and Staphylococcus aureus;10 (7.35%)strains fungi.Univariate analysis showed that the age,smoking history,history of diabetes,history of lung-related diseases,operation method,operation time,intraoperative blood loss,total postoperative thoracic drainage,mechanical ventilation time,thoracic drainage time,hospitalization time were associated with postoperative pulmonary infection of patients with lung cancer (P<0.05);the gender,ethnicity,marital status,place of residence,history of hypertension,FEV1/FVC and surgical site were not associated with postoperative pulmonary infection of patients with lung cancer (P>0.05).Logistic regression analysis showed that age ≥ 60 years old,history of smoking,history of diabetes,history of lung-related diseases,operation method (thoracotomy),operation time ≥ 3 hours,intraoperative blood loss ≥ 200 mL,postoperative thoracic drainage volume≥ 600 mL,mechanical ventilation time ≥ 12 h,thoracic drainage time ≥ 5 days and hospitalization time ≥ 20 days were independent risk factors for postoperative pulmonary infection of patients with lung cancer (P<0.05).Conclusion　The incidence of postoperative pulmonary infection of patients with lung cancer is high,and age ≥ 60 years old,history of smoking,history of diabetes,history of lung-related diseases,operation method (thoracotomy),operation time ≥ 3 hours,intraoperative bleeding volume ≥200 mL,postoperative thoracic drainage volume ≥600 mL,mechanical ventilation time ≥12 hours,pleural drainage time ≥5 days and hospitalization time ≥20 days were independent risk factors for postoperative pulmonary infection of patients with lung cancer.

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更新日期/Last Update: 2022-02-05