肿瘤化疗骨髓抑制期医院感染的危险因素分析  

Risk factors for nosocomial infections during myelosuppression period of tumour chemotherapy

作　　者：李莉[1] 张萍[1] 康焕珍[1] 潘维[2] 

机构地区：[1]武汉科技大学附属天佑医院肿瘤科,湖北武汉430064 [2]武汉科技大学附属天佑医院药剂科,湖北武汉430064

出　　处：《中华医院感染学杂志》2013年第18期4394-4395,4398,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(31271395)

摘　　要：目的分析肿瘤化疗骨髓抑制期医院感染的危险因素及干预对策,为降低化疗患者骨髓抑制期医院感染风险提供依据。方法选取2005年3月-2012年3月收治的9137例接受化疗的肿瘤患者,按照其是否接受骨髓抑制期护理干预分为干预组(4670例)和未干预组(4467例),对比两组患者的感染情况并分析感染因素,探讨干预对策。结果未干预组共出现103例医院感染,感染率2.3%,干预组共出现41例医院感染,感染率0.9%,干预组医院感染率明显低于未干预组(P<0.05);多因素回归分析显示,白细胞下降、侵入性操作和应用激素是导致肿瘤化疗患者骨髓抑制期医院感染的独立危险因素(P<0.05)。结论应针对肿瘤化疗骨髓抑制期医院感染的危险因素,给予心理护理、营养支持、定期消毒等护理干预,并注射粒细胞刺激因子、局部灌注抗菌药物等手段,改善其免疫功能,预防医院感染,保证患者生存质量。OBJECTIVE To analyze the risk factors for nosocomial infections during the myelosuppresslon perloa ot tumor chemotherapy and put forward the intervention countermeasures so as to provide basis for reducing the risk of nosocomial infections. METHODS A total of 9137 cases of tumor patients who underwent chemotherapy in the hospital from Mar 2005 to Mar 2012 were enrolled in the study and divided into the intervention group（4670 case） and the non-intervention group（4467 case） according to the status of acceptance of nursing intervention during themyelosuppression period, then the incidence of nosocomial infections was analyzed, the risk factors for nosocomial infections were observed so as to put forward the intervention countermeasures. RESULTS The nosocomial infec- tions occurred in 103 patients of the non-intervention group with the infection rate of 2.3 % ,while the nosocomial infections occurred in 41 cases of the intervention group with the infection rate of 0.9%, the infection rate of the intervention group was significantly lower than that of the non-intervention group（P〈0.05）. The multivariate regression analysis showed that the declined leucocytes,invasive operation, and use of hormone were the independent risk factors leading to the nosocorniai infections in the tumor patients during the rnyelosuppression period （P 〈 0.05）. CONCLUSION In response to the risk factors for the nosocomial infections during the myelosuppression period of chemotherapy,it is necessary to carry out such nursing interventions as the psychological nursing, nutritional support, and regular disinfection, to inject the granuloeyte colony-stimulating factor, and to perform the local perfusion antibiotics so as to improve their immunities and prevent nosocomial infections as well as ensure the quality of life of the patients.

关 键 词：恶性肿瘤 化疗 骨髓抑制期 干预 

分 类 号：R181.32[医药卫生—流行病学]