华西口腔医学杂志

• 口腔肿瘤学专栏 • 上一篇    下一篇

老年口腔鳞状细胞癌患者术后手术区域感染的风险因素研究

王强 张竹 张士岩 陈世润   

  1. 沈阳医学院附属中心医院口腔颌面外科,沈阳 110024
  • 收稿日期:2015-09-16 修回日期:2015-12-18 出版日期:2016-04-01 发布日期:2016-04-01
  • 通讯作者: 陈世润,主任医师,学士,E-mail:chenshirun@yahoo.com.cn
  • 作者简介:王强,副主任医师,学士,E-mail:wq43332007@126.com

Study of the risk factors of postoperative surgical site infection in geriatric patients with oral squamous cell carcinoma

Wang Qiang, Zhang Zhu, Zhang Shiyan, Chen Shirun.   

  1. Dept. of Oral and Maxillofacial Surgery, Affiliated Central Hospital of Shenyang Medical College, Shenyang 110024, China
  • Received:2015-09-16 Revised:2015-12-18 Online:2016-04-01 Published:2016-04-01

摘要:

回顾性分析接受手术治疗的老年口腔鳞状细胞癌患者术后发生的手术区域感染(SSI)的各种危险因素。方法  回顾分析接受手术治疗的143例老年口腔鳞状细胞癌患者的住院病史,将相关因素分为流行病学因素、肿瘤因素、合并症因素和围手术期因素4类,以是否出现术后SSI作为主要的结果变量。对所有变量用χ2检验进行单因素方差分析,并以单因素方差分析所得的危险因素来建立logistic逐步回归模型进行多因素分析。结果 143例口腔鳞状细胞癌患者中,33例患者发生术后SSI。单因素方差分析显示,与SSI发生相关的因素有患者年龄、体重指数(BMI)、肿瘤部位、肿瘤大小、糖尿病、慢性阻塞性肺疾病、美国麻醉医师协会(ASA)评分、Charlson合并症指数(CCI)、成人合并症评估-27(ACE-27)评分、术前放疗、缺损修复方法、手术时间、输血。logistic多元回归分析显示,BMI、糖尿病、ASA评分、ACE-27评分、手术时间和缺损修复方法是预测术后SSI发生的6个独立参数。结论 对老年口腔鳞状细胞癌患者术前应充分评估术后发生SSI的各类相关因素。

关键词: 老年患者, 鳞状细胞癌, 术后感染, 手术区域感染

Abstract:

Objective To review and analyze the risk factors of postoperative surgical site infection (SSI) in geriatric patients who undergo surgical treatment of oral squamous cell carcinoma. Methods A retrospective study was conducted on 143 geriatric patients who have undergone surgical treatment of oral squamous cell carcinoma. Factors were classified into four types, namely, characteristics, tumor factors, general comorbidity factors, and perioperative factors. The primary outcome variable was the presence of SSI. A logistic stepwise regression model was used for the subsequent multivariate analysis, wherein only significant risk factors in the univariate analysis were included. Results Among 143 cases, 33 showed postoperative SSI. Results of univariate analysis indicated that risk factors included age, body mass index (BMI), tumor location, tumor size, diabetes, chronic obstructive pulmonary disease, American Society of Anesthesiologists (ASA) score, Charlson comorbidity index (CCI), adult comorbidity evaluation-27 (ACE-27) score, previous radiotherapy, reconstructive method, operation time, and blood transfusion. Among these factors, six parameters were identified to have a significant factor association with the development of SSI, namely BMI, diabetes, ASA score, ACE-27 score, operation time, and reconstructive method. Conclusion Special attention should be given to factors associated with the development of SSI before operation of geriatric patients with oral squamous cell carcinoma.

Key words: geriatric patient, squamous cell carcinoma, postoperative infection, surgical site infection