乳腺癌患者手术后化疗的感染状况研究  

Prevalence of postoperative infection in breast cancer patients undergoing chemotherapy

作　　者：周韬[1] 庄亚强[1] 曾健[1] 曹一鸣[1] 黄佳鹏[1] ZHOU Tao;ZHUANG Ya-qiang;ZENG Jian;CAO Yi-ming;HUANG Jia-peng(Liuzhou People＇s Hospital,Liuzhou,Guangxi 545006,China)

机构地区：[1]广西柳州市人民医院乳腺甲状腺外科,广西柳州545006

出　　处：《中华医院感染学杂志》2018年第22期3478-3481,共4页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区卫生厅自等经费基金资助项目(Z2014434)

摘　　要：目的探索乳腺癌患者手术后化疗的感染类型及病原菌情况。方法选取2014年1月-2018年1月于医院接受治疗的294例乳腺癌患者为研究对象,统计发生术后感染患者的不同感染部位,收集临床资料及相关手术因素并分析其与患者术后感染的相关性,采集乳腺癌术后感染患者血液进行病原菌培养,统计病原菌种类。结果本次研究共发现58例术后感染患者,术后感染率为19.73%,感染患者中呼吸道感染发生率最高,共发生30例占51.72%。有骨髓抑制、引流天数>10天、输血情况(未过滤白细胞)是影响乳腺癌患者术后感染的相关因素,差异有统计学意义(P<0.05)。骨髓抑制、引流天数是造成乳腺癌术后化疗感染的独立危险因素(P<0.05)。58例乳腺癌术后感染患者共分离出46株病原菌,其中革兰阴性菌共27株占58.70%,革兰阳性菌共16株占34.78%。15株大肠埃希菌耐药率为86.67%;9株肺炎克雷伯杆菌耐药率为88.89%;11株金黄色葡萄球菌耐药率为100.00%。结论乳腺癌妇女手术后化疗感染率较高,感染部位中呼吸道感染占比较大,临床治疗时应该对骨髓抑制、引流天数、输血情况等进行密切关注以降低术后感染率,乳腺癌妇女术后感染以革兰阴性菌为主。OBJECTIVE To investigate the types of postoperative infection in the breast cancer patients undergoing chemotherapy and analyze the species of pathgeons.METHODS A total of 294 breast cancer patients who were treated in the hospital from Jan 2014 to Jan 2018 were recruited as the study objects,the infection sites of the patients with postoperative infection were statistically analyzed,the clinical data were collected,the related factors for the postoperative infection were analyzed,the blood specimens that were collected from the patients with postoperative infection were cultured,and the species of pathogens were statistically analyzed.RESULTS Totally 58 patients had postoperative infection,with the incidence rate 19.73%;the incidence rate of respiratory tract infection was the highest,totally 30 patients had the respiratory tract infection,accounting for 51.72%.The myelosuppression,drainage duration more than 10 days and blood transfusion（unfiltered white blood cells）were the related factors for the postoperative infection in the breast cancer patients,and there were significant differences（P〈0.05）.The myelosuppression and drainage duration were the independent risk factors for the postoperative infection in the breast cancer patients undergoing chemotherapy（P〈0.05）.Totally 46 strains of pathogens were isolated from the 58 breast cancer patients with postoperative infection,27（58.70%）of which were gram-negative bacteria,and 16（34.78%）were gram-positive bacteria.The drug resistance rate of the 15 strains of Escherichia coli was 86.67%,the drug resistance rate of the 9 strains of Klebsiella pneumoniae was 88.89%,and the drug resistance rate of the 11 strains of Staphylococcus aureus was 100.00%.CONCLUSIONThe incidence rate of postoperative infection is high in the breast cancer patients undergoing chemotherapy,the patients with respiratory tract infection are dominant.It is necessary for the hospital to attach great importance to the myelosuppression,drainage duration and blood transfusion

关 键 词：乳腺癌 术后化疗 感染状况 病原菌 

分 类 号：R737.9[医药卫生—肿瘤]