人表皮生长因子受体-2阳性大肠癌患者院内感染的高危因素  

Risk factors of nosocomial infection in patients with colorectal cancer of human epidermal growth factor receptor-2 positive

作　　者：吴福红[1] 李雪华[1] 詹其林[1] 

机构地区：[1]上海市第六人民医院金山分院血液肿瘤科,上海201500

出　　处：《中华实验和临床感染病杂志（电子版）》2016年第3期294-297,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：上海市金山区卫生系统优秀青年人才培养计划(No.JWKJ-RCYQ-201208)

摘　　要：目的探讨与大肠癌术后并发院内感染相关的危险因素,以指导临床采取合理的防治措施。方法选择2012年1月至2014年2月收住本院的80例大肠癌根治术后患者作为研究对象。其中,男性48例,女性32例。患者年龄41-79岁,平均年龄（59.5±18.5）岁。住院期间发生院内感染19例。对患者年龄、性别、病变部位、基因类型、感染部位、病原菌类型、围术期接受激素/抗菌药物的情况以及住院时间等维度的指标进行比较,考察与患者发生院内感染相关的影响因素。结果大肠癌患者术后是否发生院内感染,与其年龄（OR=9.67,95%CI：1.13-16.83）、基因类型（HER-2）（OR=7.32,95%CI：1.32-19.81）、感染部位（OR=5.98,95%CI：1.25-10.74）、病原菌类型（OR=6.44,95%CI：1.06-14.73）、围术期激素/抗菌药物的使用（OR=0.66,95%CI：0.02-3.88）、住院时间（OR=4.79,95%CI：1.00-9.91）等因素均有相关性,其中,〉60岁（χ^2=11.18、P=0.02）、HER-2（＋）（χ^2=9.89、P=0.04）,伤口/吻合口的感染（χ^2=7.21、P=0.01）、合并G-杆菌感染（χ^2=11.33、P=0.03）以及围术期使用激素/抗菌药物（χ^2=10.94、P=0.04）、住院时间长（χ^2=5.91、P=0.03）均是其相关危险因素。结论临床科室需加强对大肠癌患者术后住院期间发生感染的监控和防范,合理应用激素或抗菌药物,加强对手术吻合口处的清洁和消毒,尤其对于老龄患者,需尽量改善患者的营养状况和提高免疫力,以降低院内感染的发生率。Objective To explore the related risk factors of nosocomial infection in patients with colorectal cancer postoperative, and to provide a available reference data for the clinical reasonable prevention measures. Methods From 2012 January to 2014 February, a total of 80 cases of hospitalized patients with radical resection of colorectal cancer selection were selected, with 48 cases of male, 32 cases of female; with of the age 41-79 years old, the average age was（59.5 ± 18.5） years old. There were 19 cases with hospital infection. The hospitalized infection were compared with the patients without infection in age, sex, the lesion, gene type, infection sites, pathogenic bacteria types, perioperative hormone/antibiotics, and hospitalization time and other indexes, in order to find the influencing factors on nosocomial infection. Results Nosocomial infection in the patients with colorectal cancer postoperative were significantly correlated with their age（OR = 9.67, 95%CI： 1.13-16.83）, gene types（HER-2）（OR = 7.32, 95%CI： 1.32-19.81）, the sites of infection（OR = 5.98, 95%CI： 1.25-10.74）, pathogenic bacteria types（OR = 6.44, 95%CI： 1.06-14.73）, perioperative hormone/antibiotics use（OR = 0.66, 95%CI： 0.02-3.88）, hospitalization time and other factors（OR = 4.79, 95%CI： 1.00-9.91）. And age of older than 60 years old（χ^2 = 11.18, P = 0.02）, HER-2（＋）（χ^2 = 9.89, P = 0.04）, wound/anastomotic infection（χ^2 = 7.21, P = 0.01）, anastomotic/with G- infection（χ^2 = 11.33, P = 0.03）, perioperative use of hormones/antimicrobial agents（χ^2 = 10.94, P = 0.04） and the length of hospitalization（χ^2 = 5.91, P = 0.03） were the risk factors of infection. Conclusions The clinicians should strengthen the patients of colorectal cancer postoperative on monitoring and preventing the influencing factors of infection, including shortening the hospital period, rational use of hormones or antibiotics, strengthening the surgical anastomosis cleaning and disinfection, espec

关 键 词：结直肠肿瘤 交叉感染 影响因素 

分 类 号：R735.34[医药卫生—肿瘤]