383例恶性肿瘤患者化疗期间医院感染的临床分析  

Clinical analysis of nosocomial infection during chemotherapy in 383 patients with malignant tumor

作　　者：董伟[1] 皈燕[2] 王碧娟 谢小亭[1] 张波[1] DONG Wei;GUI Yan;WANG Bi-juan;XIE Xiao-ting;ZHANG Bo(Department of Internal Medicine,Second Affiliated Hospital of North Sichuan Medical College;Department of Oncology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院第二附属医院内科 [2]川北医学院附属医院肿瘤科,四川南充637000

出　　处：《川北医学院学报》2018年第5期708-711,共4页Journal of North Sichuan Medical College

基　　金：四川省基层卫生事业发展中心科研项目(SWD218-Y-19)

摘　　要：目的:分析某医院恶性肿瘤患者化疗期间医院感染的临床资料,探讨患者医院感染的发生率、病原菌的分布及易感因素,为预防与治疗医院感染提供参考依据。方法:选取383例恶性肿瘤化疗患者的临床资料,采用回顾性调查方式进行分析,使用SPSS 17. 0统计软件对数据进行处理分析。结果:383例患者中36例化疗期间发生医院感染,感染率为9. 40%;发生医院感染的原发肿瘤类型以肺癌患者居多,占18. 56%;感染部位以呼吸系统为主,占52. 78%;感染的病原菌主要是革兰阴性菌27株,占51. 92%,以铜绿假单胞菌、肺炎克雷伯菌为主;其次为革兰阳性菌20株,占38. 46%,以金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌为主;真菌5株,占9. 62%,以白色假丝酵母菌为主。发生医院感染的易感因素包括老年患者、原发肿瘤类型、既往放疗史、使用多疗程化学药物史、静脉插管及胸腹腔引流等侵入性操作、伴有基础疾病、骨髓抑制及免疫功能低下、使用激素和抗生素史等。结论:恶性肿瘤患者是感染的高发人群,化疗期间医院感染率高,应当采取多种措施加以干预,合理使用医疗技术和抗菌药物降低医院感染发生率。Objective： To analyze the clinical data of nosocomial infection during chemotherapy in a hospital,to investigate the incidence of nosocomial infection,distribution of pathogens and susceptibility factors in such patients,and to provide reference for the prevention and treatment of nosocomial infection. Methods： The clinical data of 383 patients with chemotherapy for malignant tumors were selected and analyzed retrospectively.SPSS 17.0 statistical software was used to process the data. Results： Among the 383 patients,36 patients had nosocomial infection during chemotherapy.The infection rate was 9.40%.The primary type of nosocomial infection was lung cancer,accounting for 18.56%.Respiratory system was the main site of infection,accounting for 52.78%.The main pathogens of infection were 27 strains of gram-negative bacteria,accounting for 51.92%,mainly pseudomonas aeruginosa and Klebsiella pneumoniae,followed by 20 strains of gram-positive bacteria,accounting for 38.46%,with staphylococcus aureus,staphylococcus epidermidis and staphylococcus haemolyticus were the main strains.5 strains were fungi,accounting for 9.62%,mainly of candida albicans.The predisposing factors for nosocomial infection include elderly patients,type of primary tumor,history of previous radiotherapy,history of using multiple courses of chemotherapy,invasive procedures such as venous catheterization and thoracicoabdominal drainage,underlying diseases,bone marrow suppression,low immune function,and the history of using hormones and antibiotic. Conclusion： Patients with malignant tumors are a high-incidence population with high infection rates during chemotherapy.A variety of measures should be taken to intervene them.Reasonable use of medical technology and antimicrobial agents can reduce the incidence of nosocomial infections.

关 键 词：恶性肿瘤 医院感染 化疗 

分 类 号：R181.32[医药卫生—流行病学]