肿瘤患者腹腔复杂感染的临床特点分析  

Clinical characteristics of tumor patients with complicated intra-abdominal infections

作　　者：章宝云 赵擎宇[1,2] 方翼[2] 徐大志[3] 顾葆春[2] 王慧[1,2] 

机构地区：[1]中山大学肿瘤防治中心医院感染管理科,广东广州510060 [2]中山大学肿瘤防治中心医院重症医学科,广东广州510060 [3]中山大学肿瘤防治中心医院结直肠外科华南肿瘤学国家重点实验室,广东广州510060

出　　处：《中华医院感染学杂志》2015年第21期4937-4940,共4页Chinese Journal of Nosocomiology

基　　金：国家卫计委卫生科技发展中心基金资助项目(卫技WH2011-01-02)

摘　　要：目的分析肿瘤患者腹腔复杂感染的特点,为医院感染预防控制提供参考依据。方法回顾性分析2009年1月-2014年12月144例肿瘤患者腹腔感染的临床资料,用SPSS19.0统计软件进行数据录入和分析。结果144例腹腔复杂感染肿瘤患者中有114例行手术治疗,其余30例为化疗或放疗等非手术治疗;共有102例患者发展为脓毒症,发生率为70.8%,20例发展为严重脓毒症,发生率为13.9%,22例发展为脓毒症休克,发生率为15.3%,死亡25例病死率为17.4%;所有患者感染标本共检出病原菌253株,检出革兰阴性菌最高占46.1%,其次革兰阳性菌占29.5%、真菌占24.4%。结论肿瘤患者腹腔复杂感染以术后吻合口瘘导致的感染常见,且易发展为严重的腹腔感染,预后较差;感染多由肠道混合菌群感染所致,其耐药率较高。OBJECTIVE To investigate the characteristics of the tumor patients with complicated intra-abdominal infections so as to provide guidance for control and prevention of the nosocomial infections.METHODS The clinical data of 144 tumor patients with intra-abdominal infections who were treated from Jan 2009 to Dec 2014 were retrospectively analyzed,and the statistical analysis of data was performed with the use of SPSS19.0software.RESULTS Of the 144 tumor patients with complicated intra-abdominal infections,114 received the postoperarive treatment and the rest of 30 cases received the non-surgical procedures such as chemotherapy and radiotherapy;102cases developed to sepsis,with the incidence rate of 70.8%;20cases developed to severe sepsis,with the incidence rate of 13.9%;22cases developed to septic shock,with the incidence rate of 15.3%,and 25 cases died,with the mortality rate of 17.4%.A total of 253 strains of pathogens were isolated from all of the specimens,of which 46.1% were gram-negative bacteria,29.5% were gram-positive bacteria,and 24.4% were fungi.CONCLUSION The postoperative anastomotic fistula is common among the tumor patients with complicated intraabdominal infections and is prone to develop to the severe infection,with the prognosis poor.The infections are mainly caused by the mixed intestinal flora which are highly drug-resistant.

关 键 词：肿瘤患者 腹腔复杂感染 病原菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]