Risk Factors And Etiological Characteristics After Radical Resection Of Esophageal Carcinoma

Objective Through the retrospective analysis of the preoperative,intraoperative and postoperative indicators of patients undergoing radical resection of esophagus cancer,the risk factors affecting postoperative infection were analyzed.Analysis of drug susceptibility to different infection sites and related pathogenic bacteria after operation.Avoid infection and use antibiotics as early as possible before susceptibility results are returned.Methods A retrospective analysis of 326 patients who underwent radical resection of esophageal cancer in the General Hospital of Ningxia Medical University from February 2008 to February 2018.106 patients had postoperative infection and 220 patients had no postoperative infection.According to whether infection occurred after operation,they were divided into infection group and non-infection group.Collect the basic information,basic diseases,intraoperative indicators,postoperative complications,infection sites,infectious bacteria and drug sensitivity results of each patient,and analyze the relationship between.Evaluate the impact of various indicators on infection and the drug sensitivity of pathogenic bacteria in patients with esophageal cancer after surgery.The spss23 statistical software is used to analyze the data,and the normal measurement data is expressed by "mean ±SD".If the two groups of data are consistent with normality and homogeneity of variance,two independent sample t-tests are selected.The counting data are expressed by frequency or percentage,and the sample rate is compared by χ 2 test.if any expected value in the table is less than 5,Fisher exact test is used instead of Pearson chi-square test(Chi-square test includes Fisher test).After univariate analysis,those with statistical significance were included in the multivariate analysis,and the multivariate analysis was conducted by Logistic regression model.p<0.05,it was considered that the difference was statistically significant.Results Among the 326 patients with esophageal cancer included in the study,age,diabetes history,hypoproteinemia,operation method,operation time,postoperative anastomotic leakage,and postoperative respiratory failure were the risk factors for postoperative infection of esophageal cancer.The difference was statistically significant(p<0.05).Among them,age > 60,operation time > 4 hours,open surgery,anastomotic leakage,and respiratory failure were independent risk factors for pulmonary infection after radical resection of esophagus cancer,and the difference was statistically significant(p<0.05).A total of 164 strains of bacteria were detected in patients with postoperative infection,of which 115 strains were the most detected in sputum.The pathogenic bacteria causing infection after esophageal cancer surgery are sensitive to aminoglycosides,β-lactams and glycine ring antibiotics.Conclusion1.Hypoalbuminemia,open surgery,and postoperative anastomotic leakage are independent risk factors for infection in patients undergoing radical resection of esophageal cancer.2.The common site of postoperative infection in esophageal cancer is lung infection,mainly caused by Gram negative bacteria.3.If the postoperative infection is caused by Gram negative bacteria,tobramycin and ciprofloxacin can be used for anti infection treatment.For gram-positive bacteria,anti infection treatment with tigecycline and dafopratin can be selected.