|
|
Analysis of Relationship of Preoperative Lower Respiratory Tract Colonization with Postoperative Pulmonary Infection in Patients with Non-small Cell Lung Cancer |
WANG Li, REN Ming-zhi, JIANG Peng |
Department of Oncology,Xi'an International Medical Center Hospital,Shaanxi Xi'an 710100 |
|
|
Abstract 【Objective】To investigate the relationship of preoperative lower respiratory tract colonization with postoperative pulmonary infection in patients with non-small cell lung cancer (NSCLC). 【Methods】A total of 82 patients with NSCLC who underwent surgery in our hospital from November 2019 to April 2021 were selected as the research subjects. Accorded to the presence or absence of airway colonized pathogen/bacteria in the lower respiratory tract before surgery, they were divided into groups with airway colonization group and non-airway colonization group.The postoperative pulmonary complications of the two groups were compared. The distribution of pathogenic bacteria in patients with lung infection after operation was analyzed. The clinical data of patients with lung infection and uninfected lungs after surgery were compared. Logistic multivariate regression analysis of influencing risk factors of postoperative lung infection in NSCLC patients was analyzed. 【Results】There was no statistically significant difference in the incidence of subcutaneous emphysema, pulmonary embolism, hoarseness, and chylothorax between the airway colonized bacteria group and the non-airway colonized bacteria group (P>0.05). The incidence of pulmonary infection in the airway colonized bacteria group was 25.00%, which was higher than that in the non-airway bacteria group 5.26% (P<0.05). Among 13 patients with lung infections, 23 strains were detected. Of which, gram-negative bacteria, gram-positive bacteria and fungi accounted for 56.52%, 39.13%, and 4.35% of the total number of pathogens, respectively. The proportion of postoperative lung infection patients with smoking history, white blood cell count (WBC), operation time, hospital stay, invasive procedures, and preoperative airway colonized bacteria were higher than those of patients without lung infection (P<0.05). Logistic regression analysis showed that invasive operations and preoperative airway colonization bacteria were risk factors for postoperative lung infection in NSCLC patients (OR=2.852, 3.425, P<0.05). 【Conclusion】Preoperative airway colonized pathogen/bacteria in the lower respiratory tract of NSCLC patients increases the incidence of postoperative lung infection. Invasive procedures and preoperative airway with colonized bacteria are risk factors for postoperative lung infection in NSCLC patients. Attention should be paid to strengthen precautions in clinical practice.
|
Received: 15 August 2022
|
|
|
|
|
[1] 程治强,崔恩华,白卫云.非小细胞肺癌化疗患者Nrf2表达与远期疗效临床分析[J].实验与检验医学,2020,38(2):151-153.
[2] 范金斌,李军,朱丹.非小细胞肺癌患者血清术前白蛋白/球蛋白比值与患者术后生存率的相关性分析[J].实验与检验医学,2019,37(5):163-167.
[3] 高珂,赖玉田,黄 健,等.肺癌肺叶切除患者术前存在气道定植菌与术后肺炎的发生有相关性吗?[J].中国肺癌杂志,2017,4(20):27-35.
[4] MURPHY T F,BRAUER A L,SETHI S,et al.Haemophilus haemolyticus:a human respiratory tract commensal to be distinguished from Haemophilus influenzae[J].J Infect Dis,2007,195(1):81-89.
[5] 吴小军,聂汉祥.呼吸系统疾病并发症鉴别预测与治疗[M].上海:科学技术文献出版社,2011:158-165.
[6] 陆永绥,张伟民.临床检验管理与技术规程[M].浙江:浙江大学出版社,2014:128-139.
[7] MUN M,NAKAO M,MATSUURA Y,et al.Video-assisted thoracoscopic surgery lobectomy for non-small cell lung cancer[J].Gen Thorac Cardiovasc Surg,2018,66(11):626-631.
[8] 张琦,刘淑贤,王立国,等.非小细胞肺癌患者术后肺部感染与致病性气道定植菌的关系[J].解放军医药杂志,2020,32(9):19-23.
[9] 彭武君,张文林,刘君德,等.气道定植菌对肺癌患者术后肺部感染的影响因素分析[J].中华医院感染学杂志,2019,29(4):36-39.
[10] 陈双喜,陈云,张忠俊,等.非小细胞肺癌患者术后医院感染病原菌分布特点及影响因素分析[J].临床肺科杂志,2020,25(1):122-125.
[11] 黄文杰.社区获得性肺炎的诊治现状[J].医学临床研究,2020,37(2):161-163. |
|
|
|