口腔癌患者术后肺部感染危险因素的meta分析

doi:10.19438/j.cjoms.2023.05.015

摘要/Abstract

摘要： 目的：系统评价口腔癌患者术后肺部感染的危险因素。方法：计算机检索PubMed、Web of Science、Embase、Cochrane Library、ScoPus、中国知网、万方、维普、中国生物医学文献数据库中关于口腔癌患者术后肺部感染危险因素的研究,包括病例对照研究和队列研究,检索时限为建库至2022年11月1日。结果：最终纳入11篇文献,共3 458例患者。Meta分析结果显示,吸烟史[OR=5.88,95%CI(1.49,23.26),P=0.011]、糖尿病史[OR=2.64, 95%CI(1.20,17.54),P=0.023]、既往放疗史[OR=8.21, 95%CI(1.45,46.468),P=0.017]、术前口腔卫生不良[OR=10.17,95%CI(2.14,48.32),P=0.004]、手术时间[OR=1.34,95%CI(1.12,1.61),P=0.001]、麻醉时间[OR=2.04,95%CI(1.262,3.298),P=0.004]、皮瓣大小[OR=1.02,95%CI(1.008,1.034),P=0.001]、皮瓣类型[OR=17.71,95%CI(4.15,75.56),P=0.0001]、延迟活动（>4天）[OR=4.20,95%CI(1.057,17.074),P=0.04]、术后住院时间[OR=1.14,95%CI(1.05,1.24),P=0.002]是口腔癌患者术后肺部感染的独立危险因素,术前血清白蛋白水平[OR=0.79,95%CI(0.67,0.94),P=0.005]是口腔癌患者术后肺部感染的保护因素。单因素分析显示,年龄、气管切开、术中失血量、下颌骨切除、气管套管留置时间、皮瓣修复与口腔癌患者术后肺部感染密切相关,但尚无证据证明是口腔癌患者发生术后肺部感染的独立危险因素。结论：口腔癌患者术后肺部感染影响因素较多,应进行针对性、个体化干预,预防肺部感染发生,对促进口腔癌患者术后康复具有重要意义。

关键词: 口腔癌, 肺部感染, 呼吸道感染, 危险因素, Meta分析

Abstract: PURPOSE: To systematically review the influencing factors of postoperative pulmonary infection in patients with oral cancers. METHODS: The database of PubMed, Web of Science, Embase, Cochrane Library, Scopus, CNKI, Wanfang, VIP, China Biomedical Literature Database were searched through computer for studies on the influencing factors of postoperative pulmonary infection in oral cancer patients, including case-control studies and cohort research, the search time limit was from the establishment of the database to November 1, 2022. RESULTS: Finally, 11 articles were included, with a total of 3 458 patients. Meta-analysis results showed that smoking history[OR=5.88, 95%CI(1.49,23.26), P=0.011], diabetes history[OR=2.64, 95%CI(1.20,17.54), P=0.023], previous radiotherapy history[OR=8.21, 95%CI(1.45,46.468), P=0.017], poor preoperative oral hygiene [OR=10.17, 95%CI(2.14,48.32), P=0.004], operation time[OR=1.34, 95%CI(1.12,1.61), P=0.001], anesthesia time[OR=2.04, 95%CI(1.262,3.298), P=0.004], flap size [OR=1.02, 95%CI(1.008,1.034), P=0.001],flap type[OR=17.71, 95%CI(4.15,75.56), P=0.0001], delayed activity (>4 days)[OR=4.20, 95%CI(1.057,17.074), P=0.04], and postoperative hospital stay[OR=1.14, 95%CI(1.05,1.24), P=0.002] were independent risk factors for postoperative pulmonary infection in patients with oral cancer; age tracheotomy, intraoperative blood loss, mandibular resection, tracheal tube indwelling time, and flap repair were influencing factors for postoperative pulmonary infection in patients with oral cancers. Preoperative serum albumin level[OR=0.79, 95%CI(0.67,0.94), P=0.005] was protective factor for postoperative pulmonary infection in patients with oral cancers. CONCLUSIONS: There are many factors that affect postoperative pulmonary infection in patients with oral cancers. Targeted and individualized intervention should be carried out to prevent the occurrence of pulmonary infection, which is of great significance to promote postoperative rehabilitation of patients with oral cancers.

Key words: Oral cancer, Lung infection, Tract infection, Risk factors, Meta-analysis

中图分类号:

R739.8

陈玉, 陶明, 雷银富, 吴和梅, 彭晓峰, 苟登群. 口腔癌患者术后肺部感染危险因素的meta分析[J]. 中国口腔颌面外科杂志, 2023, 21(5): 511-517.

CHEN Yu, TAO Ming, LEI Yin-fu, WU He-mei, PENG Xiao-feng, GOU Deng-qun. Meta-analysis on risk factors for postoperative pulmonary infection in patients with oral cancers[J]. China J Oral Maxillofac Surg, 2023, 21(5): 511-517.

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