侯春玲

doi：10.3969/j.issn.1007-614x.2014.14.16

摘 要 目的：研究食管癌患者术后肺部感染围手术期的影响因素。方法：2013年1月-2014年1月收治食管癌患者99例，其中感染患者为观察组，未感染患者为对照组，对两组在围手术期的影响因素进行对比。结果：本次99例食管癌患者出现肺部感染15例，发病率15.15%，影响因素包括术前、术中、术后3个阶段，吸烟时间长、年龄大、并发症多、肺活量低、手术时间长、主动脉弓上有吻合口平面、继发性神经损伤、抑酸剂以及经硬膜外间隙自控镇痛时间长均是导致肺部感染的因素。结论：食管癌术后出现肺部感染的因素众多，必须对每一步骤的治疗操作严格把关，降低术后肺部感染的几率。

关键词 食管癌 肺部感染 围手术期 影响

Evaluation of the influence of the peri operation factors on the patients with pulmonary infection after the operation of esophageal carcinoma

Hou Chunling

The Infection office of central hospital in Jinan City，Shandong Province，250013

Abstract Objective：To study the influence factor of perioperative period of postoperative pulmonary infection perioperative in patients with esophageal carcinoma.Methods： 99 cases of patients with esophageal carcinoma were admitted from January 2013 to January 2014.The cases with infection were designated as the observation group，and the uninfected cases were as the control group.Then compare the influence factors in perioperative period of two groups.Results：There were 15 cases of patients with infection in 99 cases of patients with esophageal carcinoma，and the incidence rate was 15.15%.The influence factors included three stages of preoperative，intraoperative and postoperative.A long time smoking，old age，many complications，low vital capacity，long operation time，the aortic arch with anastomotic plane，the secondary nerve injury，acid suppression agent and long epidural self-control analgesia clearance time were all the factors causing pulmonary infection.Conclusion：There were many factors causing pulmonary infection in esophageal carcinoma postoperative.It must strictly monitor every step of the reatment operation to reduce the risk of postoperative pulmonary infection.

Key words Esophageal carcinoma；Pulmonary infection；Perioperative period；Influence

食管癌手术涉及的项目复杂，受感染因素众多，因此术后容易出现并发症，尤其是吻合口瘘以及肺部并发症具有较高的致死率。由于医疗技术的不断发展，吻合口瘘设备得到更多的应用，使得吻合口瘘的治疗以及预防取得了进步，但是对肺部并发症一直没有较好的控制措施，使其成为术后最主要的致死病因[1]。对此，本文选取本院2013年1月-2014年1月99例患者进行研究，旨在了解肺部感染的主要影响因素，并提出有效的预防措施。

资料与方法

2013年1月-2014年1月收治食管癌患者99例。男69例，女30例，年龄32～77岁，平均（53.8±11.9）岁，存在并发症的患者23例，包括高血压6例，冠心病3例，支气管炎7例，糖尿病7例，支气管扩张3例，并且有22例患者有20年以上的抽烟史。均使用硬膜外复合全身麻……