摘要
目的分析研究胸、腹腔镜联合食管癌微创根治术后合并肺部感染的危险因素,降低术后肺部感染率。方法以2007年7月-2012年5月行胸、腹腔镜联合食管癌微创根治术治疗的153例食管癌患者为研究对象,将术后肺部感染的发生率与患者临床特征、外科手术参数、术后并发症等进行相关性研究。结果 153例腔镜联合食管癌手术患者,术后发生肺部感染18例,感染率为11.8%;肺部感染率≥60岁高龄患者为16.5%,合并基础疾病者为24.4%,长期吸烟史者16.7%,术前接受放疗者为23.1%,手术持续时间≥4h者为17.1%,术中出血≥500ml患者为25.0%,纵隔食管床重建途径者为15.2%,术后出现喉返神经损伤者为36.4%,各组间比较,差异均有统计学意义(P<0.05)。结论患者年龄、合并基础疾病、吸烟史、术前放疗、手术时间、术中出血情况、上消化道重建途径、是否存在喉返神经损伤等是腔镜联合食管癌微创根治术后肺部感染危险因素,了解并重视这些因素,发挥腔镜技术优势,食管癌术后肺部感染率将能得到明显降低。
OBJECTIVE To analyze and investigate the risk factors for pulmonary infections after thoracoscopy and laparoscopy combined with minimally invasive esophagectomy（MIE） so as to reduce the incidence of postoperative pulmonary infections. METHODS A total of 153 patients undergoing thoracoscopy and laparoscopy combined MIE from Jul 2007 to May 2012 were selected as the study objects, the correlation between the incidence of postoperative pulmonary infections and clinical parameters, surgical parameters, or postoperative complications was analyzed. RESULTS The postoperative pulmonary infections occurred in 18 of 153 patients with esophageal cancer with the infection rate of 11.8 %. The incidence of postoperative pulmonary infections was 16.5 % in the patients with more than 60 years of age, 24.4% in the patients complicated with underlying diseases, 16.7% in the patients with long history of smoking, 23. 1% in the patients receiving preoperative radiotherapy, 17. 1% in the patients with the operation duration more than 4 hours, 25. 0% in the patients with intraoperative blood loss more than 500ml, 15.2% in the patients with mediastinal esophageal bed reconstruction route, and 36. 4% in the patients with recurrent laryngeal nerve injury, the difference between the various groups was statistically significant （P 〈 0. 05）. CONCLUSION The age, comorbidity, smoking history, operation duration, preoperative radiotherapy, intraoperative blood loss, upper gastrointestinal reconstruction route, and recurrent laryngeal nerve injury are the risk factors for postoperative pulmonary infections after MIE. The incidence rate of pulmonary infections after the esophagectomy can be significantly reduced by focusing on the risk factors and taking advantages of the endoscopy technique.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第6期1349-1350,1358,共3页
Chinese Journal of Nosocomiology
基金
浙江省科技厅资助项目(2011C13039-2
2011R09040-3)
关键词
食管癌
胸腔镜
腹腔镜
肺部感染
Esophageal cancer
Thoracoscope
Laparoscope
Pulmonary infection
