乳腺癌术后化疗患者感染类型及危险因素分析  

Risk factors for infections in breast caner patients after chemotherapy

作　　者：周毅[1] 吴池华[1] 

机构地区：[1]四川省人民医院外科,四川成都610072

出　　处：《中华医院感染学杂志》2014年第24期6179-6181,共3页Chinese Journal of Nosocomiology

基　　金：四川省科技厅基金资助项目(30305020900)

摘　　要：目的探讨乳腺癌术后化疗患者感染类型及相关危险因素,为临床预防感染提供参考。方法回顾性分析2012年6月-2014年1月医院277例乳腺癌术后接受化疗患者的临床资料,对化疗后发生感染类型及病原菌分布特点进行收集统计,并对发生感染的危险因素进行相关因素分析,采用SPSS15.0软件进行统计分析。结果48例术后患者发生医院感染,感染率17.2%,主要的感染类型以呼吸道为主,共21例占43.7%;共分离出41株病原菌,其中以革兰阴性菌为主,共18株占43.9%;多因素logistic回归分析显示,年龄、血清白蛋白<35g/L、QLQ-BR23评分、CD4+/CD8+比值>1.33、抗菌药物使用>2种、白细胞计数<4×109/L、化疗周期>3个、乳癌扩大根式术、住院时间是患者化疗后发生感染的高危因素。结论乳腺癌术后化疗患者感染可受到多种危险因素引起,临床应当针对这些危险因素加强感控措施,降低感染率的发生。OBJECTIVE To explore the related risk factors for different types of infections in the breast cancer pa‐tients after chemotherapy so as to provide guidance for clinical prevention of the infections .METHODS The clinical data of 277 breast cancer patients who underwent the postoperative chemotherapy in the hospital from Jun 2012 to Jan 2014 wee retrospectively analyzed ,then the types of the infections and the distribution of pathogens were sta‐tistically analyzed ,the probable risk factors for the infections were analyzed ,and the statistical analysis was per‐formed by using SPSS15 .0 software .RESULTS The postoperative nosocomial infections occurred in 48 patients with the infection rate of 17 .2% ,among whom the patients with respiratory tract infections were dominant ,ac‐counting for 43 .7% （21 cases） .A total of 41 strains of pathogens have been isolated ,including 18 （43 .9% ） strains of gram‐negative bacteria .The multivariate logistic regression analysis indicated that the age ,serum albu‐min level less than 35 g/L ,QLQ‐BR23 score ,CD4 ＋ /CD8 ＋ more than 1 .33 ,use of more than 2 types of antibiot‐ics ,white blood cells counts less than 4 ＆#215; 109/L ,more than 3 cycles of chemotherapy ,extended radical surgery of breast cancer ,and length of hospital stay were the high risk factors for the nosocomial infections after chemothera‐py .CONCLUSION There are a variety of risk factors for the infections in the breast cancer patients after chemo‐therapy .It is necessary for the hospital to strengthen the infection control measures in response to the risk factors so as to reduce the infection rate .

关 键 词：乳腺肿瘤 化疗 医院感染 病原体 危险因素 

分 类 号：R619.3[医药卫生—外科学]