恶性肿瘤患者血流感染死亡的危险因素分析  

Risk factor analysis of blood stream infections in patients with malignant tumors

作　　者：徐海燕[1] 王延风[1] 冯沙娜 朱宇[2] 吴熙[1] 吴晓明[1] 于雷[1] 

机构地区：[1]中国医学科学院肿瘤医院综合科,北京100021 [2]中国医学科学院肿瘤医院检验科,北京100021

出　　处：《中华医院感染学杂志》2014年第23期5842-5844,共3页Chinese Journal of Nosocomiology

基　　金：北京希望马拉松专项基金资助项目(LC2013B36)

摘　　要：目的探讨恶性肿瘤患者发生血流感染的特点及其死亡的危险因素,为更好地预防和治疗血流感染提供临床依据,从而降低血流感染的病死率。方法回顾性分析医院2012年3月-2014年3月收治123例血流感染患者临床资料,采用SPSS16.0进行统计分析。结果 123例血流感染患者死亡31例,90d住院病死率为25.2%;共检出127株病原菌,其中以革兰阴性菌为主,共68株占53.7%;单因素分析显示,恶性肿瘤并发血流感染与出现呼吸衰竭、肾功能衰竭、高Pitt菌血症评分以及使用升压药物等因素有关,差异有统计学意义(P<0.05),多因素logistic分析显示,使用升压药物、高Pitt菌血症评分、出现呼吸衰竭与恶性肿瘤患者发生血流感染的死亡显著相关。结论血流感染病死率较高,使用升压药物、高Pitt菌血症评分、出现呼吸衰竭是恶性肿瘤患者并发血流感染死亡最主要的危险因素。OBJECTIVE To study the clinical characteristics and related risk factors of blood stream infections （BSIs）in patients with malignant tumors and to provide clinical basis for the prevention and treatment of BSIs , thus to reduce the mortality in BSIs . METHODS This retrospective cohort study was conducted among 123 patients with BSIs in our hospital from Mar .2012 to Mar .2014 .RESULTS Of the 123 patients ,31 patients died , and in‐hospital mortality for 90‐day was 25 .2% .Totally 127 strains of pathogenic bacteria were detected .Among them gram‐negative bacteria was in the majority （68 strains ） , accounting for 53 .7% . Single‐factor analysis showed that BSIs were highly related to respiratory failure ,renal failure ,the type of admissions ,high Pitt bacte‐remia scores ,the need for vasopressors and so on .The difference was significant （P〈0 .05） .Multi‐logistic anal‐ysis revealed that four clinical factors had a significant association with mortality including the need for vasopres‐sors ,high Pitt bacteremia scores ,the type of admissions and the presence of respiratory failure .CONCLUSION Mortality of BSIs remains high ,the need for vasopressors ,high Pitt bacteremia scores ,the type of admissions and the presence of respiratory failure are associated with incidence of mortality among patients with BSIs .

关 键 词：血流感染 危险因素 肿瘤 

分 类 号：R181.32[医药卫生—流行病学]