| 摘要: |
| 目的探讨口腔颌面部肿瘤患者接受根治切除及一期钛板植入修复手术后发生感染的相关因素。方法回顾性分析口腔颌面部肿瘤行根治切除及一期钛板植入修复手术的138例患者的临床资料，分析其术后感染的相关因素；对患者性别、年龄、吸烟史、肿瘤分期、术前放疗史、术前化疗史、抗生素使用情况、手术时间、术中失血量、修复皮瓣类型、植入钛板类型及术前术后血清白蛋白、血红蛋白水平进行单因素分析，采用logistic回归模型进行多因素分析。结果患者术后感染发生率为36.2%（50/138），其中呼吸道感染54.0%（27/50）、手术伤口感染40.0%（20/50）、其他部位感染6.0%（3/50）。单因素分析显示，患者术后感染与性别、年龄、吸烟史、肿瘤分期、术前放疗史、术前化疗史、抗生素使用情况、植入钛板类型、术中失血量、术前血清白蛋白水平、术前及术后血红蛋白水平均无关（均P＞0.05），而与患者手术时间、修复皮瓣类型及术后血清白蛋白水平均有关（均P＜0.05）。多因素分析显示，患者术后血清白蛋白水平是术后感染的独立危险因素（P＜0.05）。结论口腔颌面部肿瘤患者外科钛板植入修复术后发生感染的风险较大，呼吸道感染常见；缩短手术时间、术后纠正患者低白蛋白血症或可降低术后感染风险。 |
| 关键词: 口腔颌面部肿瘤 外科 钛板植入 危险因素 感染 |
| DOI： |
| 分类号: |
| 基金项目:浙江省医药卫生科技计划项目；浙江省公益性技术应用研究社会发展项目 |
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| Risk factors of infection after radical resection with titanium implant in patients with oral and maxillofacial cancer |
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HAN Chun, ZHAO Jiazheng, WANG Kejing
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Zhejiang Carcer Hospital
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| Abstract: |
| Objective To analyze the risk factors of infection after radical resection with titanium implant in patients with oral and maxillofacial cancer. Methods The clinical data of 138 patients with oral and maxillofacial tumor undergoing radical surgery and instant titanium implant for reconstruction were retrospectively analyzed. The relationship of postoperative infection with gender, age, smoking history, tumor stage, preoperative radiotherapy/chemotherapy, usage of antibiotics, operation duration, intraoperative blood loss, type of reconstruction flap, type of titanium implants, preoperative and postoperative serum albumin, hemoglobin level were analyzed by univariate and multivariate logistic regression. Results The postoperative infection occurred in 50 patients with an infection rate of 36.2%. Among all infections, 54% was respiratory tract infections, 40% was surgical and 6% was infections in other sites. Univariate analysis indicated that the postoperative infection were associated with operation duration, titanium implants type and postoperative serum albumin level significantly (P ＜0.05). Multivariate analysis showed that postoperative serum albumin level was the independent risk factor for the postoperative infections (P＜ 0.05). Conclusion The infection rate is relatively high after radical surgery with titanium implants for patients with oral and maxillofacial cancer, and the respiratory tract infection is the most common. Shortening operation time, correcting postoperative hypoalbuminemia may effectively reduce postoperative infection rates and improve the quality of life for patients. |
| Key words: Oral and maxillofacial tumor Surgery Titanium implant Risk factor Infection |
