消化道肿瘤患者医院感染危险因素分析及治疗对策  

Risk factors of nosocomial infections and treatment strategies in patients with digestive tumor

作　　者：杨少武[1] 袁华兵[1] 何丽琳[2] 

机构地区：[1]天门市第一人民医院药剂科,天门市431700 [2]天门市第一人民医院肿瘤科,天门市431700

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第2期51-53,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨和分析消化道肿瘤患者合并感染的危险因素,为临床诊疗工作提供参考。方法选取2012年1月至2013年12月住院治疗的原发性消化道肿瘤患者320例临床资料,根据合并感染情况将其分为感染组(84例)和非感染组(236例),对肿瘤患者合并感染的可能危险因素进行单因素卡方检验和多元回归分析。结果消化道肿瘤患者感染率为26.3%(84/320),其中呼吸道感染占45.2%(38/84)。年龄≥65岁、住院天数≥15 d、放化疗、有侵入操作以及营养不良的患者感染分布率均较高(P<0.05)。Logistic分析,高龄(x^2=27.99,OR=4.72),长时间住院(x^2=49.18,OR=10.83),放化疗(x^2=15.99,OR=3.07),侵入操作(x^2=11.98,OR=2.46)、含5-氟尿嘧啶/吡柔比星(x^2=7.47,OR=2.18)以及营养不良(x^2=6.61,OR=2.14)均是医院感染发生的独立因素(P<0.01)。结论消化道肿瘤患者存在高龄、住院时间长、存在放化疗、有侵入性操作、含5-氟尿嘧啶/吡柔比星方案、营养不良和肿瘤晚期素等因素均可导致感染的发生,应对部分因素进行有效预防。Objective To explore the risk factors of nosocomial infections in patients with digestive tumor,and to provide guidance for the clinical diagnosis and treatment.Methods Total of 320 cases with digestive tumor,who were hospitalized for treatment from January 2012 to December 2013,were divided into the infection group with 84 cases and non-infection group according to the status of nosocomial infections.And the multivariate Logistical regression analysis was performed for the risk factors.Results There were84 cases with infections,and the incidence rate was 26.3%（84/320）.The common site of infection was respiratory tract,accounting for 45.2%（38/84）.The infection rate of the patients with more than 65 years of age,length of stay more than 15 days,given chemotherapy,invasive procedure and malnutrition were significantly increased（P 〈0.05）.The results of the multivariate Logistical regression analysis revealed that more than 65 years of age（x^2 = 27.99,OR = 4.72）,length of stay more than 15 days（x^2 = 49.18,OR =10.83）,given chemotherapy（x^2 = 15.99,OR = 3.07）,invasive procedure（x^2 = 11.98,OR = 2.46）,including5-Fu/THP（x^2= 7.47,OR = 2.18） and malnutrition（x^2= 6.61,OR = 2.14） were the factors associated with the nosocomial infections in patients with digestive tumor,the differences were statistically significant（P 〈0.01）.Conclusions The incidence rate of the nosocomial infections is relatively high in the patient with the advanced age,length of stay,chemotherapy,invasive procedures,malnutrition and the advanced stage of tumor,thus it is necessary to take the effective measures in response to the risk factors.

关 键 词：消化道肿瘤 医院感染 抗菌药物 

分 类 号：R735[医药卫生—肿瘤]