老年肺肿瘤患者化疗后医院感染的危险因素  

Risk factors of nosocomial infections in elderly patients after lung cancer chemotherapy

作　　者：张学青[1] 

机构地区：[1]济宁市第一人民医院呼吸内科,山东济宁272000

出　　处：《中华医院感染学杂志》2013年第14期3340-3341,3344,共3页Chinese Journal of Nosocomiology

基　　金：济宁市科技局科学技术进步项目(K2008-3-35-4)

摘　　要：目的探讨老年肺肿瘤患者化疗后医院感染的危险因素,以期提高患者的生命质量和延长生命。方法选取2009年4月-2012年4月医院治疗的160例老年肺肿瘤患者化疗后医院感染临床资料进行回顾性分析,对医院感染的各项因素进行单因素分析。结果低蛋白血症、有皮肤或黏膜糜烂、存在侵入性操作、有陪护感染、长期使用广谱抗菌药物(≥20d)、住院时间长(>40d)是医院感染的危险因素;160例患者中合并感染42例,感染率为26.2%,因感染死亡9例,死亡率为5.6%;感染部位以肺部感染为主,19例占45.2%,其他感染部位依次为尿道感染、口腔真菌感染、胃肠炎症、皮肤化脓性感染、带状疱疹,分别占19.0%、12.0%、12.0%、7.1%、4.7%;从42例感染患者中选择31例进行细菌培养,共分离病原菌43株,以肺炎克雷伯菌最多,18株占41.9%,其中合并2种病原菌感染的8例、3种病原菌感染的5例、>4种病原菌感染的3例。结论低蛋白血症、侵入性操作、使用广谱抗菌药物>20d、住院时间>40d、有皮肤或黏膜糜烂是医院感染的危险因素,而肺癌、白细胞降低是高危因素,应针对危险因素,采取相应的预防措施,从而控制和减少医院感染的发生。OBJECTIVE To investigate and analyze the risk factors of nosocomial infections in the elderly patients after lung cancer chemotherapy so as to improve the patient＇s quality of life and prolong life.METHODS The clinical data of 160 cases of elderly lung cancer patients with nosocomial infections who were treated in the hospital from Apr 2009 to Apr 2012 were retrospectively analyzed,then the univariate analysis was performed for the risk factors of the nosocomial infections.RESULTS The univariate analysis indicated that the hypoproteinemia,skin or mucosal erosion,invasive operation,infections in the accompany,use of broad-spectrum antibiotics more than 20 days,and hospitalization duration more than 40 days were the risk factors of the nosocomial infections.Of totally 160cases of patients,the infections occurred in 42 cases with the infection rate of 26.2%,among which 9cases died because of the infection with the mortality of 5.6%.There were 19（45.2%）cases of patients with pulmonary infections,which was the predominant infection site,followed by the urinary tract infections（19.0%）,oral fungal infections（12.0%）,gastrointestinal tract infections（12.0%）,purulent skin infections（7.1%）,and herpes zoster（4.7%）.Totally 31of 42cases of patients with infections were chosen for the bacterial culture;a total of 43strains of pathogens were isolated,among which Klebsiella pneumoniae was dominant,accounting for 41.9%（18strains）;there were two cases complicated with two species of pathogens infections,five cases complicated with three species of pathogens infections,and three cases complicated with more than four species of pathogens infections.CONCLUSION The hypoproteinemia,invasive operation,use of broad-spectrum antibiotics for more than 20 days,length of stay more than 40 days,and the skin or mucosal erosion are the risk factors for the nosocomial infections,and the lung cancer and leukopenia are the high risk factors.It is necessary to take the targeted prevention measures according to the risk

关 键 词：肿瘤 化疗 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]