222例小细胞肺癌病例分析及合并感染危险因素和抗菌药物应用调查  

Investigation of 222 cases with SCLC and risk factors of concurrent infections and application of antimicrobial agents

作　　者：李然[1] 孙艳[1] 王睿[1] 鞠红梅[2] 李碧艳[1] 白楠[1] 刘浩[1] 孙纯广[1] 刘丽华[3] 冯丹[3] 

机构地区：[1]解放军总医院药品保障中心,北京100853 [2]吉林油田总医院,吉林松原131106 [3]解放军总医院医疗统计科,北京100853

出　　处：《中国药物应用与监测》2010年第1期26-28,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：目的:研究小细胞肺癌(SCLC)的流行病学、治疗方法、院内感染的危险因素及抗菌药物的应用。方法:回顾性调查我院2002年1月–2006年12月222例SCLC患者的病例资料,并分析SCLC病例特点,合并感染危险因素及抗菌药物应用情况。结果:222例SCLC患者中,男女比例为3.6∶1,平均年龄(57.7±11.7)a,吸烟指数>400的占58.1%,局限期132例(59.5%),广泛期73例(32.9%)。222例患者中有32例未治疗(转院或放弃治疗),57例(25.7%)手术治疗,其余采用单纯化疗或放、化疗结合疗法。共53例患者发生感染82例次,感染发生率为23.9%。采用logistic分析证明反复住院、化疗是SCLC患者院内感染的危险因素。抗菌药物以头孢菌素类、氟喹诺酮类为主,应用基本合理。结论:反复住院、化疗的SCLC患者是院内感染的高发人群,应重点予以关注;在SCLC患者的感染治疗中应严格掌握适应证,控制用药量,合理使用抗菌药物。Objective： To investigate the epidemiology of small cell lung cancer, and explore the treatment, risk factors of hospital-acquired infections and the application of antimicrobial agents in these patients. Methods： Data of 222 cases with small cell lung cancer from January 2002 to December 2006 were collected and retrospectively analyzed. The investigative contents included the risk factors of hospital-acquired infection, the application of antibacterial drugs （the category of antibacterial agents, DDDs, DUI）. Results： The cases of 222 small cell lung cancer patients were analyzed statistically, with the ratio of male to female at 3.6 ： 1, mean age （57.7 ± 11.7） years old, and the smoking index above 400 occupied 58.1%.There were 132 （59.5%） patients in limited-stage, while 73 （32.9%） in extensive-stage. Thirty-two patients were discharged without any treatment, while 57 （25.7%） patients had an operation and the rest ones went through chemotherapy and/or combined radio-chemotherapy. There were 53 patients being infected 82 times with the infection rate of 23.9%. Repeating hospitalization and chemotherapy were the special risk factors for hospital-acquired infection. Cephalosporins and quinolones took the leading places in the usage of antibacterials. Use of antibacterial agents in these cases was mainly reasonable. Conclusion： Patients with repeating hospitalization and chemotherapy are high-risk population in hospital-acquired infection. More attention should be paid to them. The treatment of infection in patients with small cell lung cancer should be strictly controlled in indications, dosage control, rational use of antimicrobial agents.

关 键 词：小细胞肺癌 院内感染 限定日剂量 药物利用指数 

分 类 号：R734.2[医药卫生—肿瘤]