老年肺癌患者化疗期间医院感染的危险因素分析  

Analysis of risk factors of nosocomial infection in elderly patients with lung cancer during chemotherapy

作　　者：丁和国[1] 徐玥[1] 刘顺林[1] 黄龙武[1] DING Heguo;XU Yue;tIU Shunlin;HUANG tongivu(Department of Respiratory Diseases,Huzhou Third People＇s Hospital in Zhejiang Province,Huzhou 313000, China)

机构地区：[1]浙江省湖州市第三人民医院呼吸科,浙江湖州313000

出　　处：《中国现代医生》2017年第30期15-18,27,共5页China Modern Doctor

基　　金：浙江省医药卫生科技项目(科研基金项目)(2017KY646)

摘　　要：目的统计老年肺癌患者临床资料,对围手术期医院感染的危险因素进行分析。方法收集2012年1月~2017年1月期间在我科接受肺癌化疗治疗的443例60岁以上患者的基本信息及临床资料进行回顾性研究。按患者是否发生医院感染将其分为感染组和非感染组,将资料统计分析后确定高危因素。结果据统计443例患者中共有112例患者发生不同部位或程度的感染,发生率为25.3%。其中以下呼吸道和上呼吸道感染最为常见,分别占37.5%和33.0%。统计分析结果显示,PS评分≥2分(P=0.022)、患有慢性阻塞性肺疾病(P=0.015)、患者糖尿病(P=0.038)、有吸烟史(P=0.041)、营养状况差[血清白蛋白(<35 g/L)](P=0.028)、接受放射治疗(P=0.004)、化疗前外周血白细胞数<4×109/L(P=0.002)及T细胞总数及亚群异常(P=0.025)是老年肺癌患者化疗期间发生医院感染的独立危险因素(P<0.05)。结论老年肺癌患者化疗治疗期间医院感染原因复杂,积极治疗患者基础疾病,及早戒烟,加强化疗期间营养支持,注意升白治疗并给予免疫疗法,均有助于降低老年患者医院感染发生率。Objective To count the clinical data of elderly patients with lung cancer, and to analyze the risk factors of perioperative hospital infection. Methods A retrospective study was conducted to collect the basic information and clinical data of 443 patients over 60 years old who underwent lung cancer chemotherapy from January 2012 to January 2017. According to whether the patients had nosocomial infection, the patients were divided into the infected group and non-infected group. The risk factors were determinedafter the statistical analysis of the data. Results According to statistics, there were 112 patients with different parts or degree of infection in 443 patients, with the incidence of 25.3%. The lower respiratory and upper respiratory tract infection was the most common, accounting for 37.5% and 33.0% respectively. Statistical analysis results showed that PS score≥2 points（P=0.022）,chronic obstructive pulmonary disease（P=0.015）, diabetes mellitus （P=0.038）, smoking history（P=0.041）, poor nutritional status（serum albumin〈35g/t）, receiving radiation therapy（P=0.004）, peripheral blood leukocyte count〈4×10^9/t before chemotherapy（P=0.002）, total T cell count and subgroup abnormalities（P=0.025） were the independent risk factors for nosocomial infection during chemotherapy in elderly patients with lung cancer（P〈0.05）. Conclusion The causes of nosocomial infection in elder-ly patients with lung cancer are complicated. The active treatment underlying diseases of patients, early smoking cessa- tion, strengthening nutrition support during chemotherapy, paying attention to elevatingwhite blood cell therapy and immunotherapy will help reduce the incidence of nosocomial infection in elderly patients.

关 键 词：肺癌 化疗 医院感染 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]