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口腔癌患者非计划再次手术的影响因素分析

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目的 分析口腔癌患者非计划再次手术(UR)的相关影响因素。方法 选取2018年1月1日至2022年12月31日四川大学华西口腔医院头颈肿瘤外科160例口腔癌UR患者为研究组,另以1:1配对选取同期未发生UR的160例患者为配对组,比较两组临床资料,筛选符合要求的变量,进一步采用多因素logistic逐步回归模型分析口腔癌UR的影响因素。结果 口腔癌患者UR多发生于术后1 d内(66。88%),原因主要为皮瓣血管危象(48。13%);与配对组比较,研究组患者住院时间延长,住院费用增多,差异均有统计学意义(P<0。05)。多因素logistic逐步回归分析结果显示:清蛋白和中性粒细胞-淋巴细胞比值评分(ANS,OR=1。693,95%CI:1。207~2。347,P=0。002)、手术前后血红蛋白水平差值(OR=1。056,95%CI:1。035~1。077,P<0。001)、游离组织瓣修复(OR=4。609,95%CI:2。350~9。036,P<0。001)是口腔癌患者发生UR的影响因素。结论 UR延长患者住院时间,增加患者住院费用。ANS高、手术前后血红蛋白水平差值大、行游离组织瓣修复是口腔癌患者发生UR的独立危险因素。
Analysis of influencing factors of unplanned reoperation in patients with oral cancer
Objective To investigate the related influencing factors of unplanned reoperation (UR) in patients with oral cancer.Methods A total of 160 oral cancer patients with UR who were hospitalized in the Department of Head and Neck Oncology,West China Hospital of Stomatology,Sichuan University from Janu-ary 1,2018 to December 31,2022 were selected as the study group,and another 160 patients without UR in the same period were selected as the matching group by 1:1 matching.The clinical data of the two groups were compared.The variables that met the requirements were screened.The multivariate logistic stepwise regres-sion model was further used to analyze the influencing factors of UR in oral cancer.Results UR mostly oc-curred within one day after surgery in patients with oral cancer (66.88%),mainly due to flap vascular crisis (48.13%).Compared with the matched group,the hospitalization time of the study group was prolonged,the hospitalization cost was increased,and the differences were statistically significant (P<0.05).Multivariate lo-gistic stepwise regression analysis showed that albumin and neutrophil-lymphocyte-ratio score (ANS,OR=1.693,95%CI:1.207-2.347,P=0.002),difference in hemoglobin levels before and after surgery (OR=1.056,95%CI:1.035-1.077,P<0.001) and free tissue flap repair (OR=4.609,95%CI:2.350-9.036,P<0.001) were the influencing factors for UR in patients with oral cancer.Conclusion UR prolongs the hospi-talization time and increases the hospitalization cost of patients.High ANS,large difference in hemoglobin lev-els before and after surgery,and free tissue flap repair are independent risk factors for UR in patients with oral cancer.

oral cancerunplanned reoperationalbuminneutrophil-to-lymphocyte ratiohemoglobinfree tissue flapinfluencing factorscase-control study

王光满、毕小琴

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四川大学华西护理学院,成都 610041

口腔疾病防治全国重点实验室/国家口腔医学中心/国家口腔疾病临床医学研究中心/四川大学华西口腔医院头颈肿瘤外科,成都 610041

口腔癌 非计划再次手术 清蛋白 中性粒细胞与淋巴细胞比值 血红蛋白 游离组织瓣 影响因素 病例对照研究

四川省科技计划成都市卫生健康委医学科研项目

2022JDKP00072022015

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(9)