| Xin Huang,Xin Xu,Zhanfa Sun,Jing Chen,Hong Fang. Analysis of the relationship between deep venous catheter-related infection and post-operative complications in patients receiving minimally invasive esophagectomy. Oncol Transl Med, 2020, 6: 64-67. |
| 患者深静脉置管相关性感染与微创食管切除术后并发症的相关性分析 |
| Analysis of the relationship between deep venous catheter-related infection and post-operative complications in patients receiving minimally invasive esophagectomy |
| Received:August 28, 2019 Revised:May 08, 2020 |
| DOI：10.1007/s10330-019-0377-7 |
| 中文关键词: 深静脉置管；导管相关性感染；微创食管切除术；并发症 |
| 英文关键词: deep venous catheterization (DVC); catheter-related infection (CRI); minimally invasive esophagectomy (MIE); complications |
| 基金项目: |
| Author Name | Affiliation | Postcode | | Xin Huang | Department of Burns and Plastic Surgery, Qingdao Municipal Hospital | 266011 | | Xin Xu | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | 266011 | | Zhanfa Sun | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | 266011 | | Jing Chen | Second Department of General Surgery, Qingdao Municipal Hospital | 266011 | | Hong Fang* | Department of Burns and Plastic Surgery, Qingdao Municipal Hospital | 266011 |
|
| Hits: 9037 |
| Download times: 10531 |
| 中文摘要: |
| 目的：评价接受微创食管切除术（MIE）患者的导管相关性感染率（CRIR），以确定最佳深静脉置管途径及CRIR与术后并发症的关系。
方法：对我院2014~2018年168例行MIE联合术前深静脉置管的食管癌患者进行分析。拔除置管后，将导管尖端连同导管内静脉血送至微生物学实验室进行菌株培养，对CRIR相关临床变量（性别、年龄、吸烟状态、饮酒状态、既往病史、肿瘤位置、组织学分级、病理TNM分期、吻合位置、吻合口瘘、吻合口狭窄、乳糜胸、肺炎、喉返神经损伤、反流性食管炎、插管部位、置管时间）进行统计评价。
结果：本研究共入组144例患者，其中颈静脉置管105例，锁骨下置管38例。这些患者的中位年龄为63岁（范围：42-79岁），置管中位时间为7天（范围：4-21天）。4例导管经培养确诊表皮葡萄球菌、金黄色葡萄球菌和白色念珠菌三种菌种种植，统计数据表明，出现导管相关感染的患者更容易发生吻合口瘘（66.67%，P<0.001）和肺炎（.27%，p<0.001）。而一些特征，如位于食管上部的肿瘤（13.6%，p=0.003）和超过7天的置管时间（10.00%，p<0.001）的CRIR更高。
结论：尽管MIE患者颈静脉和锁骨下静脉均可置管，但7天以上的DVC和上食管切除术会导致较高的CRIR，导管相关感染与吻合口瘘和肺炎有关。 |
| 英文摘要: |
| Objective The aim of the study was to evaluate catheter-related infection rate (CRIR) for patients
receiving minimally invasive esophagectomy (MIE), to identify the optimal catheterization approach and
relationship between CRIR and post-operative complications.
Methods In total, 168 patients with esophageal carcinoma and undergoing MIE combined with preoperative
deep venous catheterization (DVC) were analyzed in our institution (Qingdao Municipal Hospital,
China), from 2014 to 2018. After completing DVC, catheter-tips together with intraductal venous blood
samples were sent to the microbiology lab for bacterial strain culture. CRIR was statistically evaluated for
the following clinical variables: gender, age, smoking status, drinking status, past history, tumor location,
histologic grade, pathological T, N, and M category, anastomotic location, anastomotic leakage, anastomotic
stricture, chylothorax, pneumonia, recurrent laryngeal nerve (RLN) injury, reflux esophagitis, catheterization
site, and catheter-locking days.
Results Among the 144 patients recruited in our study, 105 catheters were inserted into the jugular vein
and 39 catheters into the subclavian vein. The median age of these patients was 63 years (range: 42–79
years), and the median catheter-locking period was seven days (range: 4–21 days). Four catheters were
identified with three types of strain colonizations, including Staphylococcus epidermidis, Staphylococcus
aureus and Blastomyces albicans. Statistical data showed that patients diagnosed with catheter-related
infection were likely to incur anastomotic leakage (66.67%, P < 0.001) and pneumonia (27.27%, P < 0.001);
features such as tumors located in the upper esophagus (13.6%, P = 0.003), and over seven catheterlocking
days (10.00%, P < 0.001) were attributed to a high CRIR.
Conclusion Although both jugular and subclavian veins can be catheterized for patients with MIE, DVC
is associated with more than seven catheter-locking days and upper esophagectomy, due to high CRIR.
Furthermore, catheter-related infection is related to anastomotic leakage and pneumonia. |
|
View Full Text
Download reader HTML全文 |
| Close |
|
|
|