甲状腺乳头状癌患者术后发生医院感染的危险因素分析

Risk factors of nosocomial infection in patients with papillary thyroid carcinoma after operation

  • 摘要: 目的 分析甲状腺乳头状癌患者术后出现医院感染的危险因素,旨在为医院感染的控制提供有效参考。方法 收集2015年1月-2016年8月医院行手术方案治疗的甲状腺乳头状癌患者100例,通过该院自制的调查问卷详细统计患者的基本资料,主要包括年龄、性别、血糖水平、有无应用抗菌药物、引流管留置及引流时间等,并通过单因素分析、多因素logistic回归分析等方法分析该疾病患者术后出现医院感染的相关危险因素。结果 100例患者中12例患者发生医院感染,感染率为12.0%;年龄≥60岁患者的感染率(16.67%)显著高于<60岁患者(6.52%);血糖水平≥6.2mmol/L患者感染率(23.81%)显著高于<6.1 mmol/L岁患者(3.45%);留置引流管患者感染率(20.59)显著高于未留置患者(7.58%);引流时间>3天患者感染率(21.05%)显著高于≤3天患者(6.45%),差异有统计学意义(P<0.05);可见患者术后发生医院感染与其年龄较大、血糖水平较高、引流管留置及引流时间较长等因素相关;多因素logistic回归分析表明,年龄≥60岁(OR值:0.51,P<0.05)、血糖水平≥6.2 mmol/L(OR值:0.25,P<0.05)、术后留置引流管(OR值:0.59,P<0.05)及引流时间>3天(OR值:1.40,P<0.05)为患者术后发生医院感染的独立危险因素。结论 甲状腺乳头状癌患者术后发生医院感染的危险因素较多,临床应采取针对性的干预措施,以有效减少医院感染。

     

    Abstract: OBJECTIVE To analyze the risk factors of nosocomial infection in patients with thyroid papillary carcinoma after operation, so as to provide effective guidance for the control of nosocomial infection. METHODS A total of 100 patients with papillary thyroid carcinoma underwent surgical treatment were collected, and their basic information were statistically analyzed by the hospital-made questionnaire, including age, gender, blood glucose level, with or without antibacterial drugs, drainage tube indwelling and drainage time. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of postoperative nosocomial infection in patients with the disease. RESULTS Among the 100 cases, 12 cases of patients occurred nosocomial infection, with the infection rate of 12%. The infection rates of patients with age ≥60 years(16.67%), blood glucose level≥6.2 mmol/L(23.81%), with indwelling drainage tube(20.59%), and drainage time>3 days were significantly higher than those of age <60 years(6.52%), blood glucose level<6.1 mmol/L, without indwelling drainage tube(7.58%) and drainage time≤3 days, and the differences were statistically significant (P<0.05). It was indicated that the incidence of nosocomial infection in patients was related to older age, higher blood glucose level, indwelling drainage tube and long drainage time. Multivariate logistic regression analysis showed that age≥ 60 years (OR=0.51, P<0.05), the blood glucose level ≥ 6.2 mmol/L (OR=0.25, P<0.05), drainage tube indwelling (OR=0.59, P<0.05) and drainage time > 3 days (OR=1.40, P<0.05) were independent risk factors of nosocomial infection for patients after surgery. CONCLUSION There are many risk factors of nosocomial infection in patients with thyroid papillary carcinoma after operation, and the corresponding intervention measures should be taken to reduce the nosocomial infection.

     

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