论文部分内容阅读
目的:探讨口腔颌面肿瘤术后感染的相关因素及防治措施。方法:回顾性分析自2008年4月~2011年4月收治的483例行口腔颌面肿瘤术患者,术后引起各种感染57例。分析感染原因、病原菌种类及耐药性。结果:(1)口腔颌面肿瘤术后感染率为11.8%(57/483);(2)颌面肿瘤患者发生感染与年龄有一定的关系,在0~3岁及大于60岁的幼儿中,感染比率为20.0%及25.6%,在4~18岁及19~60岁中,感染比率为13.5%及9.3%,P<0.005;(3)感染与侵入性操作、误吸和制动有一定的相关性;(4)感染部位分别为创面感染22例(38.6%);上呼吸道感染5例(8.8%),下呼吸道感染30例(52.6%)。革兰阳性菌感染50例(62.5%),以金黄葡萄球菌、凝固酶阴性葡萄球菌、链球菌属及真菌感染为主,革兰阴性菌感染30例(37.5%),革兰阴性菌以大肠杆菌及肺炎克雷伯菌感染为主。病菌重复率为23例。(5)住院时间<15d者,感染率为6.19%,住院时间为27d者,感染率为10.1%,住院时间>30d者,感染率为22.3%。卡方比较,P<0.005。结论:口腔颌面肿瘤术后感染发生率与患者的年龄、住院时间及部菌种类均有一定的关系。年龄大于60岁,或小于3岁者,免疫力较低,发病率也较高。住院时间越长,患者的感染率越高。病菌感染以革兰阳菌为主,革兰阴性菌仍占用一定的比例;根据感染病菌抗菌谱选择适宜的抗生素,加强院内感染的控制均可明显减少术后感染的可能性。
Objective: To investigate the related factors and prevention and treatment of postoperative infection of oral and maxillofacial tumors. Methods: A retrospective analysis of 483 patients with oral and maxillofacial tumors who were treated from April 2008 to April 2011 was retrospectively analyzed. A total of 57 cases of various infections were reported after operation. Analysis of the causes of infection, the types of pathogens and drug resistance. Results: (1) The postoperative infection rate of oral and maxillofacial tumors was 11.8% (57/483). (2) The incidence of infection in maxillofacial tumors was related to age. In children aged 0-3 years and older than 60 years , And the infection rates were 20.0% and 25.6% respectively. The infection rates were 13.5% and 9.3% at 4 to 18 years and 19 to 60 years old, respectively, P <0.005. (3) Infection and invasive procedures, aspiration and braking (4) The infection sites were wound infection in 22 cases (38.6%), upper respiratory tract infection in 5 cases (8.8%) and lower respiratory tract infection in 30 cases (52.6%). Gram-positive bacteria in 50 cases (62.5%), Staphylococcus aureus, coagulase-negative Staphylococcus, Streptococcus and fungal infections, Gram-negative bacteria in 30 cases (37.5%), Gram- Bacillus and Klebsiella pneumoniae infection. The repeat rate of bacteria was 23 cases. (5) The infection rate was 22.3% when the hospitalization time was less than 15 days, the infection rate was 6.19%, the hospitalization time was 27 days, the infection rate was 10.1%, and the hospitalization time was> 30 days. Chi square comparison, P <0.005. Conclusion: The incidence of postoperative infection in oral and maxillofacial tumors is related to the age of patients, length of hospital stay and species of bacteria. People older than 60 or under 3 years old have lower immunity and higher morbidity. The longer the hospital stay, the higher the patient’s infection rate. Infection with gram-positive bacteria, Gram-negative bacteria still occupy a certain percentage; according to the antibacterial spectrum of infection bacteria to select the appropriate antibiotics, to strengthen the control of nosocomial infections can significantly reduce the possibility of postoperative infection.