食管癌患者胸腔镜术后呼吸道感染病原菌分布与感染因素研究  

Distribution of pathogens infected in respiratory tract in patients with esophagus cancer after thoracoscopy

作　　者：郑佳[1] 吴新萍[1] 邱风兰[1] 

机构地区：[1]南阳医学高等专科学校第二附属医院护理部,河南南阳473000

出　　处：《中华医院感染学杂志》2015年第13期3040-3041,3047,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅重点基金资助项目(HW-2012-030)

摘　　要：目的：研究多中心食管癌患者胸腔镜手术后感染的病原菌分布、敏感性，分析其发生呼吸道感染的相关因素，为临床降低医院感染提供参考依据。方法采用随机抽样方法选取2003年3月－2013年3月6所医院3168例食管癌胸腔镜手术患者，调查发生呼吸道感染的病原菌分布将其敏感率，对食管癌胸腔镜手术患者的临床特征、病原菌分布、用药资料、临床疾病情况等进行总结，并分析其发生呼吸道感染的相关因素及感染率，采用SPSS13．0软件进行分析。结果85例患者发生呼吸道感染，感染率为2．68％，其中上呼吸道感染占65．88％，下呼吸道感染占34．12；共培养出病原菌132株，其中革兰阴性菌81株占61．36％，革兰阳性菌49株占37．12％；革兰阳性菌对万古霉素、替考拉宁敏感性高，为92．86％～100．00％；革兰阴性菌对亚胺培南、头孢曲松敏感性高，为89．47％～100．00％；而年龄≥60岁、住院时间≥30d、有侵入性操作、手术时间≥4 h是呼吸道感染危险因素。结论胸腔镜食管癌患者术后发生呼吸道感染病原菌多样，同时发生呼吸道感染因素多，在临床上要合理选择敏感抗菌药物控制，加强医院感染预防措施。OBJECTIVE To study the distribution and drug sensitivity of pathogens infected in respiratory tract in patients with esophagus cancer after thoracoscopy so as to analyze risk factors related to respiratory infections and provide references for reducing nosocomial infections .METHODS A total of 3168 cases of patients received thora‐coscopy from Mar .2003 to Mar .2013 in 6 hospitals were selected randomly .The pathogenic distribution ,drug sensitivity rate ,clinical features ,medical records and underlying diseases were summarized and the risk factors and infection rate were analyzed by SPSS 13 .0 software .RESULTS Totally 85 cases appeared respiratory infections with the rate of 2 .68% ,including 65 .88% of the upper respiratory tract infection and 34 .12% of the lower re‐spiratory tract infection .All together 132 strains of bacteria were cultured ,including 81 strains of gram‐negative bacteria ,accounting for 61 .36% and 49 strains of gram‐positive bacteria ,accounting for 37 .12% .Gram‐positive bacteria were highly sensitive to vancomycin and teicoplanin with the rate of 92 .86% to 100 .00% .Gram‐negative bacteria were highly sensitive to imipenem and ceftriaxone with the rate of 89 .47% to 100% .Age （≥60 years） , hospital stay （≥30 d） ,invasive operation ,surgery time （≥4 h） were risk factors for respiratory tract infections . CONCLUSION The pathogens infected by patients with esophageal cancer after thoracoscopy are various ,so as the risk factors .Antibiotics should be chosen rationally and infection preventions should be strengthened in hospitals .

关 键 词：食管癌 胸腔镜手术 感染因素 病原菌 敏感率 

分 类 号：R619.3[医药卫生—外科学]