喉癌患者术后感染的危险因素分析及干预对策探讨

目的:探讨喉癌患者手术部位发生感染(Surgical site infection,SSI)的相关危险因素及干预对策,为临床预防提供参考。方法:回顾性分析2012年7月-2013年11月因喉癌而在我院行喉切除术的83例患者的临床资料,根据术后是否发生SSI将患者分为感染组(n=12例)和非感染组(n=71例)。分析两组患者术后SSI的危险因素,并提出相应护理对策。结果:83例患者中,12例术后发生SSI,发生率为14.46%;单因素分析显示,感染组和非感染组在临床III期以上、术前气管切开、手术时间4 h、全喉切除等方面存在显著差异性(P0.05);多因素回归分析显示:患者的临床分期、术前气管是否切开、手术时间及手术切除方式是术后发生SSI的独立危险因素(P0.05)。结论:喉癌术后感染与临床分期、手术时间及切除方式等因素有关,采取有效的干预对策可减少术后SSI的发生率。

Risk Factors and Interventions of Postoperative Surgical Site Infection ofPatients with Laryngeal Cancer

Objective:To investigate the risk factors and countermeasures of postoperative surgical site infection (SSI) of patientswith laryngeal cancer so as to provide a reference for clinical prevention.Methods:The general data of 83 cases with laryngeal cancerwho were treated with laryngectomy in our hospital from July 2012 to November 2013 were retrospectivly analyzed. According to theincidence of SSI, the selected patients were divided into the infection group (n=12) and the non-infection group (n=71). Then the riskfactors for SSI were analyzed and the nursing countermeasures were discussed.Results:12 patients occurred postoperative SSI and theincidence rate was 14.46%; single factor analysis showed that there were significant differences in the clinical stage III, preoperativetracheotomy, operation time over 4 h, total laryngectomy between the infection group and the non infection group (P<0.05). Multivariatelogistic regression analysis revealed that the clinical stage, preoperative tracheotomy, operation time and laryngectomy methods were theindependent risk factors for SSI (P<0.05).Conclusion:The risk factors of postoperative SSI in laryngeal cancer are related to clinicalstage, total laryngectomy and other indicators. Effective nursing intervention applied to the corresponding factors can reduce theincidence of postoperative SSI.