甲状腺癌术后患者发生医院感染的危险因素及病原学分析  

Risk factors and etiological analysis of nosocomial infection in thyroid cancer patients

作　　者：陈璐[1] CHEN Lu(Clinical Laboratory,Jinhna Municipal Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院检验科

出　　处：《中国卫生检验杂志》2018年第24期3051-3054,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨甲状腺癌术后患者发生医院感染的危险因素,为临床早期防治提供依据。方法回顾性分析2015年1月-2017年12月本院接受甲状腺癌手术治疗的458例患者的临床资料。根据患者是否发生医院感染,分为感染组和未感染组,采用Logistic回归分析确定患者术后发生医院感染的危险因素,并分析病原学分布及病原菌耐药情况。结果 458例甲状腺癌术后患者发生医院感染28例,感染率为6. 11%;共检出68株病原菌,其中革兰阴性菌占60. 3%,革兰阳性菌占35. 3%,真菌占4. 4%; 3种主要的革兰阳性菌对青霉素、红霉素类抗生素耐药率较高,对呋喃妥因、替考拉宁及万古霉素均敏感; 3种主要革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦、美罗培南及头孢吡肟均较敏感。经Logistic回归分析显示,有COPD史、病理类型、住院时间及糖尿病史是患者发生医院感染独立的危险因素(P <0. 05)。结论甲状腺癌术后患者发生医院感染危险因素较多,临床针对相关危险因素采取早期预防,减少患者发生医院感染的发生。Objective To investigate the risk factors of nosocomial infection in postoperative patients with thyroid cancer and provide basis for clinical preventions and treatments. Methods This paper retrospectively analyzed the clinical data of 458 patients undergoing thyroid cancer surgery from January 2015 to December 2017 in our hospital. According to whether the patients suffered from nosocomial infection,they were divided into infection group and uninfected group. Logistic regression analysis was used to determine the risk factors of postoperative nosocomial infection and analyze the distribution of pathogens and drug resistance of pathogens. Results There were 28 cases of nosocomial infection in 458 cases of thyroid cancer. The infection rate was 6. 11%. A total of 68 pathogens were detected,of which Gram-negative bacteria accounted for 60. 3%,Gram-positive bacteria accounted for 35. 3%,Fungi accounted for 4. 4%; 3 main gram-positive bacterium were highly resistant to penicillin and erythromycin antibiotics,and were sensitive to nitrofurantoin,teicoplanin,and vancomycin; 3 major gram-negative bacteria were sensitive to imipenem,cefepime Ketone/sulbactam,meropenem and cefepime. Logistic regression analysis showed that history of COPD,patterns of pathology,length of inpatient,and history of diabetes were all independent risk factors for nosocomial infection( P < 0. 05). Conclusion There are more risk factors for nosocomial infection in postoperative patients with thyroid cancer. Early prevention should be taken to deal with the relevant risk factors,so as to reduce the occurrence of nosocomial infection in patients.

关 键 词：甲状腺癌手术 医院感染 危险因素 预防措施 

分 类 号：R736.1[医药卫生—肿瘤]