摘要
目的探讨乳腺癌术后Ⅱ期假体植入患者围手术期感染的相关因素及相应预防对策,为降低患者围手术期感染率、提高患者植入手术成功率提供科学依据。方法选择2012年1月-2017年6月医院进行乳腺癌术后Ⅱ期假体植入手术患者182例为研究对象,将Ⅱ期乳房假体植入术围手术期内出现感染的患者纳入感染组,未出现感染的患者纳入对照组,将年龄、体质指数、手术时间、术中出血量、术后引流时间、TNM分期、合并糖尿病情况、术前贫血情况、假体类型、保留乳头乳晕情况、腋下淋巴结清扫情况等可能影响两组患者Ⅱ期乳房假体植入围手术期感染的相关临床资料进行单因素及多因素Logistic回归分析。结果 182例进行乳房再造患者Ⅱ期假体植入术后共有21例患者出现围手术期感染,感染的发生率为11.54%。单因素及多因素Logistic回归分析结果显示手术时间、术后引流时间、体质指数≥28kg/m2、清扫腋下淋巴结、保留乳头乳晕是乳腺癌术后Ⅱ期假体植入患者围手术期感染的独立相关因素。结论乳腺癌术后Ⅱ期假体植入患者围手术期感染的相关因素较多,应全面评估患者状态,针对围手术期感染的高危人群,应加强围手术期感染的监测以及术后预防性抗感染治疗,最大程度地减少患者的感染发生,提高乳房重造的安全性和成功率。
OBJECTIVE To explore the related factors for perioperative infection in breast cancer patients undergoing stage Ⅱ prosthesis implantation and put forward the targeted prevention countermeasures so as to reduce the incidence of perioperative infection and raise the success rate of the implantation.METHODS A total of 182 breast cancer patients who received the stage Ⅱ prosthesis implantation in the hospital from Jan 2012 to Jun 2017 were recruited as the study objects,the patients who had the infection during the perioperative period of the stage Ⅱ prosthesis implantation were assigned as the infection group,while the patients who did not had the infection were set as the control group.Univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the perioperative infection,including age,body mass index,operation duration,intraoperative hemorrhage volume,postoperative drainage time,TNM stage,complication with diabetes mellitus,preoperative anemia,types of prosthesis,preservation of nipple and areola and dissection of axillary lymph nodes.RESULTS Of the 182 breast cancer patients who underwent the stage Ⅱ prosthesis implantation,21 had perioperative infection,with the infection rate 11.54%.The results of the univariate analysis and multivariate logistic regression analysis indicated that the operation duration,postoperative drainage time,body mass index no less than 28 kg/m2,dissection of axillary lymph nodes and preservation of nipple and areola were the independent related factors for the perioperative infection in the breast cancer patients undergoing the stage Ⅱ prosthesis implantation.CONCLUSION There are a variety of related factors for the perioperative infection in the breast cancer patients undergoing the stage Ⅱ prosthesis implantation.It is necessary to comprehensive evaluate the condition of the patients,strengthen the monitoring of the perioperative infection,take prevention measures after the surgery and minimize the incidence of the infection so as to raise the safety and success rate of breast reconstruction.
作者
林冬颜
程光
何昭好
林静
羊柳美
LIN Dong-yan;CHENG Guang;HE Zhao-hao;LIN Jing;YANG Liu-mei(Hainan Provincial People's Hospital,Haihou,Hainan 570311,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期106-109,共4页
Chinese Journal of Nosocomiology
基金
海南省卫生厅医学科研基金项目资助(琼卫2013资助-27)
关键词
乳腺癌
乳房切除
Ⅱ期乳房再造
感染
相关因素
Breast cancer
Mastectomy
Stage Ⅱ breast reconstruction
Infection
Related factor
