晚期鼻咽癌患者医院感染的临床分析  

Clinical analysis of nosocomial infections in patients with advanced nasopharyngeal carcinoma

作　　者：闫石[1] 温海涛[2] 王鑫[2] 

机构地区：[1]齐齐哈尔医学院附属第三医院医务科,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院附属第三医院耳鼻喉科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2015年第13期3076-3077,3080,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省科技厅科技基金资助项目(53277-DX)

摘　　要：目的调查分析晚期鼻咽癌患者行放疗联合紫杉醇化疗过程中发生医院感染的危险因素,总结临床经验,为医院感染的预防工作提供理论依据。方法随机选取医院30例行放疗联合紫杉醇化疗的晚期鼻咽癌住院患者作为研究对象,通过对临床资料的回顾性分析,研究患者医院感染的危险因素与病原菌类型。结果 30例晚期鼻咽癌住院患者中有24例发生医院感染,感染率为80.0%;感染的主要部位为呼吸道,包含口咽部鼻咽部感染21例占87.5%,肺部感染2例占8.3%,另有1例患者合并左侧胸壁带状疱疹占4.2%;共检出病原体26株,以真菌、革兰阴性菌为主,各11株各占42.3%,革兰阳性菌3株,占12.5%,带状疱疹病毒1株,占3.8%;鼻咽癌患者行放化疗联合治疗发生医院感染的危险因素包括住院时间、口腔黏膜完整性、体内白细胞水平、抗菌药物、激素类药物的应用。结论为预防医院感染,应缩短患者的治疗周期、减少患者住院时间;对患者白细胞水平下降作出积极干预;杜绝滥用抗菌药物、激素等。OBJECTIVE To investigate the risk factors for nosocomial infections in the patients with advanced naso‐pharyngeal carcinoma undergoing radiotherapy combined with paclitaxel chemotherapy and summarize the clinical experience so as to provide theoretical basis for prevention of the nosocomial infections .METHODS A total of 30 hospitalized patients with advanced nasopharyngeal carcinoma who underwent the radiotherapy combined with pa‐clitaxel chemotherapy were randomly recruited as the study objects ,then the clinical data were retrospectively ana‐lyzed ,and the risk factors for nosocomial infections and the species of pathogens were observed .RESULTS The nosocomial infections occurred in 24 of 30 patients with advanced nasopharyngeal carcinoma with the infection rate of 80 .0% ,of w hom 21 （87 .5% ） cases had the pharyngeal and nasopharyngeal infections ,2 （8 .3% ） cases had the pulmonary infections ,and 1 （4 .2% ） case had the complicated shingles in the left chest wall .Totally 26 strains of pathogens have been isolated ,including 11 （42 .3% ） strains of fungi ,11 （42 .3% ） strains of gram‐negative bacte‐ria ,3 （12 .5% ） strains of gram‐positive bacteria ,and 1 （3 .8% ） strain of herpes zoster virus .The risk factors for the nosocomial infections in the nasopharyngeal carcinoma patients undergoing the radiotherapy combined with chemotherapy included the length of hospital stay ,integrity of oral mucosa ,level of white blood cells in vivo ,and use of antibiotics and steroids .CONCLUSION To prevent the nosocomial infections ,it is necessary to shorten the treatment cycle and the length of hospital stay ,actively take the interventions to the patients with the decreased level of while blood cells ,and put an end to the abuse of antibiotics or hormones .

关 键 词：晚期鼻咽癌 放射治疗 紫杉醇 医院感染 

分 类 号：R181.32[医药卫生—流行病学]