Analysis Of Risk Factors Of Pulmonary Infection After The Resection Of Thymoma And Prevention

Bankground In Our country, thymoma is the most common primary tumor of anterior mediastinal among adults. Treatment is mainly based on surgery, radiotherapy and chemotherapy. Combination therapy can significantly improve the postoperative survival rate of patients. But because of the patient's own or other reasons, there are a series of complications after thymectomy. They can seriously affect the recovery of patients after surgery, which pulmonary infection may cause or aggravate other diseases.Objective To discuss the risk factors of pulmonary infection after thymoma, explore the effective ways to prevent postoperative pulmonary infection, reduce the incidence of pulmonary infection after thymectomy.Methods Clinical data of 254 cases of thymoma patients undergoing thoracic surgery in the First Affiliated Hospital of Zhengzhou University during May 2009 to May 2015 were reviewed. According to pulmonary infection happened or not after thymectomy,254 cases thymoma patients were divided into two groups with postoperative clinical observation. The pulmonary infection group: 78 cases, male: 55 cases, female: 23 cases, median age of 58.5(45 to 84) years old, the group without postoperative pulmonary infection : 176 cases, male: 129 cases, female: 47 cases, with an median age of 53.0(40 to 78)years old. The two groups were compared in age, gender,smoking history, preoperative pulmonary function, myasthenia gravis, diabetic complications, surgical method, operative bleeding volume,the duration of operation.To observe whether there are differences between the two groups in the above aspects.Descriptive statistical analysis method was applied to describe the basic data.Chi-square test was used to count data of two variables analysis,compared two groups of patients basic information,The screening effect with the method of logistic regression analysis correlative risk factors of pulmonary infection after thymectomy.Results1 Through statistical analysis comparison, single factor analysis showed that the patients with pulmonary infection and without pulmonary infection group,s age,smoking history, preoperative pulmonary function, myasthenia gravis, diabetic complications, surgical method, operative bleeding volume, the duration of operation,and all of them have statistical significance(P?0.05),while gender, hypertension and coronary heart disease do not produce significant differences(P>0.05).2 Multivariate logistic analysis results showed that old age, smoking history( ?400 / year), preoperative diabetes, preoperative myasthenia gravis, preoperative severe pulmonary dysfunction, traditional surgical method and operative bleeding volume(?200ml) are pulmonary infection,s independent risk factors after thymectomy(P < 0.05). The duration of operation is not pulmonary infection,s independent risk factor after thymectomy(P > 0.05).Conclusions1 There are many factors related to the occurrence of pulmonary infection after thymectomy.Smoking history( ?400 / year), old age(?50 years), preoperative diabetes, preoperative myasthenia gravis, preoperative severe pulmonary dysfunction,traditional surgical method and operative bleeding volume(?200 ml) are independent risk factors of pulmonary infection after thymectomy, while gender, coronary heart disease and hypertension are not risk factors of pulmonary infection after thymectomy.2 The duration of operation is a risk factor but not a independent risk factor of pulmonary infection after thymectomy.3 Preoperative smoking cessation, respiratory functional exercise, respiratory tract preparation, intraoperative hemostasis and other measures are taked to be able to reduce the incidence of pulmonary infection after thymectomy partly.