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目的探讨肺癌患者术后院内肺部感染的相关危险因素,提出相应的预防措施。方法回顾性分析2003年6月至2012年6月新疆医科大学第一附属医院胸外科720例肺癌患者的临床资料,其中男460例,女260例;年龄60.37(17～83)岁。通过单因素分析和多因素非条件logistic回归分析筛选肺癌患者术后发生院内肺部感染的独立危险因素。结果单因素分析结果表明,肺癌患者术后院内肺部感染与以下9项因素有关:年龄≥60岁(χ2=26.67,P=0.000),糖尿病(χ2=34.46,P=0.000),慢性阻塞性肺疾病(χ2=59.30,P=0.000),长期大量吸烟史(χ2=10.40,P=0.001),抑酸剂使用时间(χ2=7.69,P=0.006),手术时间长(χ2=38.12,P=0.000),手术方式(χ2=4.22,P=0.040),机械通气时间(χ2=21.86,P=0.000)和切口疼痛明显(χ2=19.69,P=0.000);而与术前肺功能、预防性使用抗生素、术中失血量无关。多因素分析结果表明:年龄≥60岁(χ2=5.43,P=0.020),糖尿病(χ2=8.61,P=0.003),慢性阻塞性肺疾病(χ2=9.15,P=0.002),长期大量吸烟史(χ2=5.48,P=0.019),抑酸剂使用时间长(χ2=13.21,P=0.000),手术时间长(χ2=5.36,P=0.021),机械通气时间长(χ2=5.72,P=0.017)和切口疼痛明显(χ2=3.87,P=0.049)是肺癌患者术后院内肺部感染的8个独立危险因素。结论肺癌患者术后易发生院内肺部感染,如能根据肺癌患者的特点,对相关危险因素采取预防措施,可以减少院内肺部感染的发生。
Objective To explore the related risk factors of pulmonary infection in patients with lung cancer after operation, and to put forward corresponding preventive measures. Methods The clinical data of 720 patients with lung cancer from the Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University from June 2003 to June 2012 were retrospectively analyzed. There were 460 males and 260 females, aged 60.37 (17-83 years). Univariate analysis and multivariate non-conditional logistic regression analysis were used to screen for independent risk factors for nosocomial pulmonary infection in patients with lung cancer. Results The univariate analysis showed that pulmonary nosocomial infections in lung cancer patients were related to the following 9 factors: age ≥60 years (χ2 = 26.67, P = 0.000), diabetes (χ2 = 34.46, P = 0.000), chronic obstructive Lung cancer (χ2 = 59.30, P = 0.000), long history of heavy smoking (χ2 = 10.40, P = 0.001), duration of antacid use (χ2 = 7.69, P = 0.006) (Χ2 = 4.22, P = 0.040), duration of mechanical ventilation (χ2 = 21.86, P = 0.000) and incision pain (χ2 = 19.69, P = 0.000) Sex use of antibiotics, blood loss has nothing to do. Multivariate analysis showed that chronic obstructive pulmonary disease (χ2 = 9.15, P = 0.002), long-term massive smoking history (χ2 = 5.43, P = 0.020), diabetes (χ2 = 8.61, (χ2 = 5.48, P = 0.019), long duration of antacid use (χ2 = 13.21, P = 0.000), longer operation time (χ2 = 5.36, P = 0.021) 0.017) and significant incision pain (χ2 = 3.87, P = 0.049) were 8 independent risk factors for nosocomial pulmonary infection in patients with lung cancer. Conclusions Lung cancer is likely to develop pulmonary infection in the hospital after operation. If preventive measures can be taken on the relevant risk factors according to the characteristics of patients with lung cancer, the incidence of nosocomial pulmonary infection can be reduced.