食管癌术后患者肺部感染病原菌分布及对肺功能的影响  

Distribution of pathogens causing postoperative pulmonary infection in patients with esophagus cancer and influence on lung function

作　　者：张克[1] 路遥 李德冰 梁少杰 王晓东[1] 

机构地区：[1]河南科技大学第一附属医院胸外科,河南洛阳471003

出　　处：《中华医院感染学杂志》2018年第1期73-76,共4页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅基金资助项目(LW-2010B-028)

摘　　要：目的分析食管癌术后患者肺部感染病原菌分布特点及对肺功能的影响。方法选取2015年1月-2017年1月在医院接受治疗的食管癌术后肺部感染患者41例为感染组,食管癌术后未发生肺部感染患者50例为未感染组,另纳入60名健康体检者为对照组;采集感染组患者痰液标本进行细菌培养与鉴定;比较感染组与未感染组患者术后住院时间及病死率;比较各组受试者肺功能及血清细胞因子水平。结果感染组患者术后住院时间(18.9±3.1)d,显著长于未感染组患者(P<0.05);感染组患者住院期间病死率显著高于未感染组患者(P<0.05);41例感染组患者共分离致病菌60株,革兰阴性菌35株占58.33%,革兰阳性菌22株占36.67%,真菌3株占5.00%;感染组患者肺功能指标FVC、FEV1、FEV1%及FEV1/FVC均显著低于未感染组患者及对照组,组间比较差异均有统计学意义(P<0.05);感染组患者外周血CRP、TNF-α、IL-6及IL-1β水平显著高于未感染组及对照组(P<0.05)。结论食管癌患者术后肺部感染的病原菌以革兰阴性菌为主,感染导致术后住院日及病死率增高,并恶化肺功能及系统性炎症反应。OBJECTIVE To investigate the distribution of pathogens causing postoperative pulmonary infections in patients with esophagus cancer and analyze the influence on lung function. METHODS A total of 41 esophagus cancer patients with postoperative pulmonary infections who were treated in the hospital from Jan 2015 to Jan 2017 were chosen as the infection group, 50 esophagus cancer patients who did not have postoperative pulmonary infec- tions were chosen as the non-infection group, and 60 healthy people who received physical examination were set as the control group. The sputum specimens that were obtained from the patients with the infections were cultured, and the isolated pathogens were identified. The postoperative length of hospital stay and mortality rate were com- pared between the infection group and the non-infection group, and the lung function and levels of serum cytokines were observed and compared among the three groups of participants. RESULTS The postoperative length of hospi- tal stay of the infection group was （18.9 ±3.1） days, significantly longer than the non-infection group（P 〈0,01）. The mortality rate of the infection group was significantly higher than that of the non-infection group during the hospital stay （P〈0.05）. Totally 60 strains of pathogenic bacteria were isolated from the 41 patients with infec- tions, of which 35 （58. 33%） were gram-negative bacteria, 22 （36.67%） were gram-positive bacteria, and 3 （5.00 %） were fungi. The lung function indexes FVC, FEV1, FEV1% and FEV1/FVC were significantly lower in the infection group than in the non-infection group and the control group（P〈0.05）. The levels of peripheral bloodCRP, TNF-α, IL-6 and IL-1β of the infection group were remarkably higher than that of the non-infection group and the control group（P〈0.05）. CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the postoperative pulmonary infections in the patients with esophagus cancer, the infections may extend the length of

关 键 词：食管癌 肺部感染 病原菌分析 肺功能 

分 类 号：R563.1[医药卫生—呼吸系统]