Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Surgery. 2010 Apr;147(4):497-502. doi: 10.1016/j.surg.2009.10.048. Epub 2009 Dec 11.
The presence of pathogens in dental plaque is a risk factor associated with postoperative pneumonia in esophageal cancer patients. The effectiveness of pre-operative dental brushing to decrease the risk of postoperative pneumonia in esophageal cancer patients was evaluated prospectively.
A total of 86 thoracic esophageal cancer patients who underwent an esophagectomy were investigated. Patients were divided into 2 groups: the control group (41 patients) and the pre-operative dental brushing group (45 patients). The patients in the brushing group were assigned to brush their teeth 5 times a day. After the operation, the frequency of postoperative pneumonia and need for tracheostomy for pulmonary treatment was calculated.
Postoperative pneumonia was decreased markedly from 32% to 9% (P = .013), and the frequency of postoperative pneumonia requiring tracheostomy decreased from 12% to 0% in the dental brushing group, respectively. Limiting the patients who had positive pathogenic bacteria in their dental plaque on their admission, the frequency of postoperative pneumonia was decreased from 71% (5 of 7 patients) in the control group to 17% (2 of 12 patients) in the dental brushing group (P = .045).
Frequent pre-operative dental brushing is performed easily and seems to prevent postoperative pneumonia in esophageal cancer patients.
牙菌斑中病原体的存在是与食管癌患者术后肺炎相关的一个危险因素。本研究前瞻性评估了术前刷牙对降低食管癌患者术后肺炎风险的效果。
共纳入 86 例行食管癌切除术的患者。患者分为两组：对照组（41 例）和术前刷牙组（45 例）。刷牙组患者被要求每天刷牙 5 次。计算术后肺炎和需要气管切开术进行肺部治疗的频率。
术后肺炎发生率从 32%显著下降至 9%（P =.013），需要气管切开术治疗的肺炎发生率从 12%降至 0%。限制入院时牙菌斑中存在阳性病原菌的患者，对照组（7 例中的 5 例）术后肺炎发生率从 71%降至刷牙组（12 例中的 2 例）的 17%（P =.045）。
术前频繁刷牙操作简便，似乎可以预防食管癌患者术后肺炎。
