肺癌切除术后肺部感染的药敏试验及其治疗  

Treatment and drug sensitivity test of postoperative pulmonary infection in patients with pulmonary carcinoma

作　　者：郭朝晖[1] 周仑[1] 林培裘[1] 林若柏[1] 陈椿[1] 康明强[1] 林英[1] 

机构地区：[1]福建医科大学附属协和医院胸外科,福州350001

出　　处：《海峡药学》2007年第5期58-60,共3页Strait Pharmaceutical Journal

摘　　要：目的分析肺癌术后并发肺部感染的致病因素,总结诊治经验。方法2000年1月至2005年12月共行肺癌开胸手术585例,并发术后肺部感染52例(8．89%),全组病例均行痰菌培养并做药敏试验;用SPSS 11．0软件logistic回归分析对致病因素做多因素分析。结果痰菌培养以革兰阴性杆菌为主,主要是铜绿假单胞菌、肺炎克雷伯菌和不动杆菌等。logistic回归分析示气管切开、呼吸机辅助呼吸、长期大量吸烟史和合并糖尿病等3个因素与术后并发肺部感染有关(P＜0．05)。全组病例治愈50例(96．2%),2例死于呼吸功能衰竭(3．9%)。结论气管切开、呼吸机辅助呼吸,合并糖尿病及术前长期大量吸烟是肺部感染的高危因素。对高危患者术后及时甚至多次纤维支气管镜吸痰,合理应用抗生素等有助于肺部感染的防治。OBJECTIVE To study the etiololgical factors for the pulmonary infection （PI）in postperative patients with pulmonary carcinoma, and summarize the experience of the diagnosis and treatment. METHODS From January 2000 to December 2005, of 585 cases of pulmonary carcinoma, there are 52 cases of postoperative PI, For these infected patients, sputum was taken to cultivate and drug sensitivity tests were performed. In order to perform multiple factor analysis of the etiological factors, the binomial distribution Logistic regression analysis of SPSS 11.0 was applied. RESULTS There were 50（96.2% ）cases cured,2 casesi3.9% ）died of respiratory failure. The sputum culture consist mostly of Gram-negative bacillus. CONCLUSION The following 3 factors were significantly associated with PI： smoking, diabetes, assisted ventilation and tracheotomy （ P 〈 0.05 ）. To avoid and control of PI, it may be beneficial to these patients by sucking sputum through fibrobronchoscope promptly and apply antibiotics reasenably.

关 键 词：术后肺部感染 肺癌 诊断 治疗 药敏试验 

分 类 号：R969.4[医药卫生—药理学]