Analysis Of The Related Factors Of Infection After Laryngectomy

Objective:To analyze the infection and related factors after the laryngectomy,explore the main causes of postoperative infection and put forward to control and prevention measures aiming at the main causes.Methods:Analyze retrospectively the clinical data of 342 cases,who saw a doctor,then were diagnosed as laryngocarcinoma and hospitalized and accepted the laryngectomy in the First Hospital of Jilin University from Jan 2011 to Dec 2015,and divide the patients into two groups of which one named no infection group contained the patients who were not infectious after the surgery and the other as infection group covered the patients who were combined with deep cervical infection regardless of involving the pharyngeal fistula.Deep cervical infection happened to 54 cases in the infection group,accounting for 15.8% of the ones,17 cases pharyngeal fistula included.The statistical methods in this thesis contained chi-squared test and multi-factor logistic regression analysis that we adopted when we summarized the influence factors of postoperative infection,and inspection level,that is ?,equals to 0.05,which was described as forms.Result:Collected data of 342 cases aged 36 ~ 60(not including 60)patient 164 cases,178 cases,60 or higher average age(60.08 + 8.69),postoperative infection of 54 cases(15.8%),pharyngeal fistula of 17 cases(5.0%).3 patients with preoperative radiotherapy,including infection,2 cases(66.7%),pharyngeal fistula in 1 case(33.3%).Without radiotherapy of 339 cases,51 cases of infection(15.0%),16 cases of pharyngeal fistula(31.4%).Preoperative tracheotomy,29 cases of pharyngeal fistula in 5 cases(17.2%),313 cases,the tracheostomy has 12 cases of pharyngeal fistula(3.8%).Clinical stage: 0-?period in 139 cases,including 12 cases of infection,pharyngeal fistula in 2 cases(16.7%),52 cases,of which 8 cases of infection,pharyngeal fistula in 2 ?cases(3.8%),?59 cases,including 17 cases of infection,7 cases of pharyngeal fistula(11.9%).Tumor classification,the glottis type 125 cases,including 30 cases of infection,10 cases of pharyngeal fistula(8.0%),203 cases of the glottis type,of which 17 cases of infection,pharyngeal fistula in 3 cases(1.4%),the penetration of the glottis type 8 cases,including infection,3 cases of pharyngeal fistula in 1 case(12.5%),6 cases of laryngeal cancer recurrence,3 cases of infection,were pharyngeal fistula(50%).Total laryngectomy were 75 cases,including 22 cases of infection,12 cases of pharyngeal fistula(16.0%),156 cases of laryngeal partial nephrectomy performer of 31 cases of infection,pharyngeal fistula in 5 cases(3.2%).Preoperative with basic diseases(diabetes),16 cases of infection in 5 cases,pharyngeal fistula in 2 cases(12.5%)and 326 patients without diabetes,48 cases of infection,pharyngeal fistula in 15 cases(4.6%).Chi-squared test outcomes indicated that these factors affected whether the postoperative infection happened which were clinical stage,tumor stage,length of hospital stay,preoperative tracheotomy,operation method,cervical lymph node dissection at the same time,drainage,safety margin and operation time(P<0.05).Logistic regression analysis model was established,and the results showed that history of alcoholism,operation time,clinical stage,tumor stage and operation method were independent factors of postoperative infection.Conelusion:Clinical stage,tumor stage,length of hospital stay,preoperative tracheotomy,operation method,cervical lymph node dissection at the same time,drainage,safety margin and operation time were the higher risk factors of postoperative infection after laryngectomy,and history of alcoholism,operation time,clinical stage,tumor stage and operation method were independent risk factors of postoperative infection after laryngectomy.For the laryngeal cancer patients combining with the higher risk factors,we should actively improve,dissolve and prevent the factors above-mentioned,and eventually decrease the happening rate of postoperative infection.