Infection and inflammatory response in elderly patients with oral and maxillofacial surgery / 中国医师杂志

ABSTRACT

Objective To investigate the characteristics and influencing factors of infection in elderly patients with oral and maxillofacial surgery,and to explore the effect of infection on inflammatory response-related proteins,in order to guide the clinical treatment.Methods A total of 653 cases of patients aged more than 60 who were treated with oral and maxillofacial surgery during January 2004 to December 2015 in Shenzhen People's hospital was involved and divided into infected group (n =48) and uninfected group (n =605) according to whether postoperative nosocomial infection was occurred.The characteristics and influencing factors of infection were observed.A total of 171 cases of healthy volunteers whose age and sex were matched with patients were collected as control group.The expressions of inflammatory responserelated proteins in 3 groups were compared.Results The main site of postoperative nosocomial infection was lower respiratory tract,with 15 cases of patients,accounting for 31.3％.A total of 48 strains of pathogens was isolated,the main pathogenic bacteria were Streptococcus pyogenes,with 8 strains,accounting for 16.7％.Streptococcus pyogenes had high drug resistance to erythromycin and clindamycin,and had high sensitivity to penicillin G and meropenem.Aged more than 70,operation time more than 3 h,the primary diseases as malignant tumor were the independent risk factors for postoperative nosocomial infection (P ＜0.05).Blood interleukin (IL)-1,IL-2,IL-6,IL-10,tumor necrosis factor α (TNF-α),transforming growth factor β (TGF-β) and interferon-γ (IFN-γ) in infected group were more than uninfected group and control group.The differences were statistically significant (P ＜ 0.05).Conclusions The rate of infection in elderly patients with oral and maxillofacial surgery is still high in our hospital.The main site of infection is lower respiratory tract and the main pathogens were Streptococcus pyogenes.Aged more than 70,operation time more than 3 h,the primary diseases as malignant tumor were the independent risk factors for postoperative nosocomial infection.Infection can lead to peripheral inflammatory factor levels increase significantly.