Department of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, Kakogawa, Japan; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan.
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan.
Surgery. 2019 May;165(5):1003-1007. doi: 10.1016/j.surg.2018.11.020. Epub 2019 Feb 11.
Postoperative pneumonia can be a fatal complication that may occur after lung resection in cancer patients. Some reports have shown that the incidence of postoperative pneumonia is decreased after esophageal surgery by perioperative oral care; however, there exist no data to suggest that a lack of perioperative oral care can be a risk factor for postoperative pneumonia after lung resection. To investigate the association between the preventive effect of oral care and postoperative pneumonia, we conducted a multicenter, retrospective study of lung cancer patients who underwent lung resection.
Between January 2014 and December 2016, a total of 721 patients underwent lung resections at 1 of the 6 hospitals included in our study. Among 721 patients, 280 (38.8%) received perioperative oral care, and the remaining 441 (61.2%) did not receive any such care. Propensity score matching was performed to minimize selection biases associated with the comparison of retrospective data between the oral care and control groups.
Of the 721 patients, 54 (7.5%) experienced postoperative pneumonia involving 13 of the 280 patients (4.6%) in the oral care group and 41 of the 441 patients (9.3%) in the control group (P = .02). On propensity score analysis, a significant difference was also found between oral care intervention and incidence of postoperative pneumonia (P = .002).
Our results suggest that perioperative oral care is an effective method to decrease the occurrence of postoperative pneumonia in patients who have undergone lung resection.
术后肺炎是癌症患者肺切除术后可能发生的致命并发症。一些报告显示，围手术期口腔护理可降低食管手术后的术后肺炎发生率；然而，尚无数据表明围手术期口腔护理缺失是肺切除术后肺炎的危险因素。为了研究口腔护理的预防效果与术后肺炎之间的关系，我们对接受肺切除术的肺癌患者进行了一项多中心、回顾性研究。
2014 年 1 月至 2016 年 12 月，我们研究中的 6 家医院共对 721 例患者进行了肺切除术。在 721 例患者中，280 例（38.8%）接受了围手术期口腔护理，其余 441 例（61.2%）未接受任何口腔护理。为了最小化口腔护理组和对照组之间回顾性数据比较的选择偏差，进行了倾向评分匹配。
在 721 例患者中，54 例（7.5%）发生了术后肺炎，其中 280 例口腔护理患者中有 13 例（4.6%），441 例对照组患者中有 41 例（9.3%）（P =.02）。在倾向评分分析中，口腔护理干预与术后肺炎发生率之间也存在显著差异（P =.002）。
我们的结果表明，围手术期口腔护理是降低肺切除术后患者术后肺炎发生的有效方法。
