消化道肿瘤患者内镜下黏膜剥离术后感染病原菌构成与药敏及危险因素研究  

Pathogen constituent,drug sensitivity and risk factor analysis of infections in gastrointestinal cancer patients after endoscopic submucosal dissection

作　　者：朱云燕[1] 徐建光[1] 赵黎明[1] 祝君[1] 余建香[1] 程义仙 

机构地区：[1]衢州市人民医院消化内科,浙江衢州324000

出　　处：《中华医院感染学杂志》2017年第15期3476-3479,共4页Chinese Journal of Nosocomiology

摘　　要：目的调查消化道肿瘤患者内镜下黏膜剥离术(ESD)治疗后感染病原菌分布、药敏及危险因素研究,为临床治疗提供参考依据。方法回顾性分析2012年3月-2016年3月期间526例ESD治疗后消化道肿瘤患者的细菌培养、药敏试验结果和临床资料情况。结果 526例ESD治疗后消化道肿瘤患者发生感染35例,感染率为6.7%;共分离出病原菌47株,以革兰阴性菌为主,共25株占53.2%;大肠埃希菌、铜绿假单胞菌对青霉素、氨苄西林耐药率较高,均为100.0%;logistic回归分析显示:住院时间、卧床时间、手术时间、糖尿病和操作者经验是发生治疗后感染的独立危险因素(P<0.05)。结论消化道肿瘤患者ESD治疗后发生感染的概率较低,病原菌感染以革兰阴性菌为主,耐药现象严重,临床应针对相应的危险因素采取必要措施,预防感染给患者带来的负面影响。OBJECTIVE To investigate the pathogen distribution,drug sensitivity and risk factor of infections in gastrointestinal cancer patients after endoscopic submucosal dissection（ESD）,so as to provide references for clinical treatment.METHODS Bacterial culture,drug sensitivity test results and clinical characters of 526 gastrointestinal cancer patients after ESD from Mar.2012 to Mar.2016 were retrospectively analyzed.RESULTS Among 526 gastrointestinal cancer patients after ESD,35 cases of patients had infections,and the infection rate was 6.7% .A total of 47 strains of pathogenic bacteria were isolated,which were mainly 25 strains of gram-negative bacteria,accounting for 53.19% .The resistant rates of Escherichia coli and Pseudomonas aeruginosato penicillin and ampicillin were high,which were all 100% .The logistic regression analysis showed that,length of stay,length of bed,duration of operation,diabetes and operator experience were independent risk factors of infections in gastrointestinal cancer patients after ESD（P〈0.05）.CONCLUSIONIncidence of infections in gastrointestinal cancer patients after ESD is low,and the main bacteria are gram-negative bacteria,which have severe drug resistance,and it should take effective measures according to related risk factors in clinic to prevent the negative effects of infections.

关 键 词：消化道肿瘤 内镜下黏膜剥离术 病原菌 危险因素 

分 类 号：R735[医药卫生—肿瘤]