保护性隔离措施在乳腺癌术后化疗感染患者中的效果及病原学分析  

Control effect of protective isolation measures and characteristics of pathogens in breast cancer patients with postoperative infection after chemotherapy

作　　者：潘颖[1] 蔡仕彬[1] 郑琎[1] 付春燕[1] 陈述政[1] PAN Ying;CAI Shi-bin;ZHENG Jin;FU Chun-yan;CHEN Shu-zheng(Lishui Central Hospital, Lishui, Zhejiang 323000 , China)

机构地区：[1]丽水市中心医院乳腺科,浙江丽水323000

出　　处：《中华医院感染学杂志》2019年第7期1080-1083,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金资助项目(2011KYA164)

摘　　要：目的探讨分析乳腺癌术后化疗患者感染的病原学特点,及保护性隔离对感染患者的改善效果。方法选取医院2006年1月-2016年12月收治的82例乳腺癌术后化疗患者,采取随机数字表法将患者分为试验组与对照组,每组41例。对照组患者采取常规治疗,试验组患者采取保护性隔离措施,分析比较两组患者的感染及不良反应发生情况;统计感染患者病原学特点及发生感染的影响因素。结果 82例患者共有11例发生感染,感染率13.41%;乳腺癌术后化疗患者主要表现为畏寒、体温≥38℃、引流量未减少、局部压痛、红细胞沉降率升高;试验组患者不良反应发生率低于对照组患者(P<0.05);多因素回归分析结果显示,术前接受辅助化疗、行标准根治术或扩大根治术、手术时间≥3h及引流时间≥15d是导致患者术后发生感染的影响因素(P<0.05)。结论乳腺癌术后化疗患者感染的致病菌以革兰阴性菌为主,其中肺炎克雷伯菌是造成乳腺癌患者感染的主要病原菌。应用保护性隔离措施可降低乳腺癌术后化疗患者感染发生风险,提升医疗质量。OBJECTIVE To investigate the etiological characteristics of breast cancer patients with postoperative infection after chemotherapy and to observe the improvement in patients with infections after implementation of protection isolation. METHODS 82 cases of breast cancer patients treated with chemotherapy in our hospital from Jan. 2016 to Dec. 2016 were selected and divided into two groups by the random number table method, with 41 cases in each group. The observation group were treated with protective isolation measures, whereas the control group received routine treatment. The incidence of infection and adverse reactions were analyzed and compared between the two groups. The etiological characteristics of the infected patients and the influencing factors on the infection were analyzed. RESULTS There were 11 cases of infection in the 82 patients, and the infection rate was 13.41 %. The main manifestations of breast cancer patients after chemotherapy were chills, high body temperature (> 38 C), no reduction of drainage flow, local tenderness and increased erythrocyte sedimentation rate. The incidence of adverse reactions in the experimental group was significantly lower than that in the control group (P<0.05). Multivariate regression analysis showed that adjuvant chemotherapy before operation, standard radical operation or expansion radical operation, long operation time (> 3 hours) and long drainage time (> 15 days) were the influencing factors of infection after operation (P<0.05). CONCLUSION Gram-negative bacteria are the main pathogens in breast cancer patients with postoperative infection after chemotherapy. Klebsiella pneumoniae is the main pathogen that causes infection in patients with breast cancer. The application of protective isolation measures can reduce the risk of postoperative infection in breast cancer patients after chemotherapy, and improve the quality of medical care.

关 键 词：肺炎克雷伯菌 革兰阴性菌 保护性隔离 乳腺癌 

分 类 号：R619.3[医药卫生—外科学]