老年肺癌根治术后患者院内感染的相关因素分析  

Analysis of the factors related to nosocomial infection in elderly patients with lung cancer after radical operation

作　　者：孔羽 崔嬿嬿 韩月玲[1] 杨利[1] 陈艳萍[1] KONG Yu;CUI Yanyan;HAN Yueling;YANG Li;CHEN Yanping(Department of Intensive Care Unit,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,He’nan,China)

机构地区：[1]郑州大学第一附属医院综合ICU

出　　处：《癌症进展》2019年第21期2589-2592,共4页Oncology Progress

摘　　要：目的探讨老年肺癌根治术后院内感染的相关因素。方法选取行肺癌根治术治疗的老年肺癌患者196例,对患者术后院内感染的发生情况、感染部位、病原菌分布情况及病原菌耐药情况进行分析,并对老年肺癌患者术后发生院内感染的影响因素进行分析。结果196例老年肺癌患者中,30例(15.3%)患者术后发生院内感染,其中呼吸系统感染所占比例最高,为60.0%(18/30)。30例发生院内感染的患者中,共分离出病原菌45株;其中革兰阴性菌28株(62.2%),革兰阳性菌14株(31.1%),真菌3株(6.7%)。革兰阴性菌中,铜绿假单胞菌对头孢哌酮、头孢他啶的耐药率较高;肺炎克雷伯菌对头孢曲松、阿米卡星的耐药率较高。革兰阳性菌中,金黄色葡萄球菌、表皮葡萄球菌对红霉素和青霉素的耐药率均较高。真菌中,光滑假丝酵母对伊曲康唑的耐药率为100%,白假丝酵母对伏立康唑的耐药率为100%。年龄为70~85岁、合并基础疾病、住院时间≥1个月、有静脉穿刺的老年肺癌患者术后院内感染的发生率分别高于年龄为65~69岁、未合并基础疾病、住院时间﹤1个月、无静脉穿刺的患者(P﹤0.05);多元Logistic回归分析结果显示:年龄为70~85岁、合并基础疾病、有静脉穿刺、住院时间≥1个月是老年肺癌患者术后发生院内感染的独立危险因素(P﹤0.01)。结论肺癌根治术后老年肺癌患者的院内感染发生率较高,且受多种因素影响,临床应采取有效的预防措施,以降低院内感染发生率。Objective To explore the factors related to nosocomial infection after radical resection of lung cancer in elderly patients.Method There were 196 elderly patients with lung cancer who underwent radical resection of lung cancer were included in the research.The incidence of nosocomial infection,infection site,distribution of pathogenic bacteria and drug resistance were analyzed,besides,the factors associated with nosocomial infection in these elderly patients with lung cancer were assessed.Result Among the 196 elderly patients with lung cancer,30(15.3%)patients had nosocomial infection,with respiratory tract infection being the most common one,accounting for 60.0%(18/30)of all cases.From the 30 patients with nosocomial infection,45 strains of pathogenic bacteria were isolated,including 28 strains(62.2%)of gram-negative bacteria,14 strains(31.1%)of gram-positive bacteria,and 3 strains(6.7%)of fungi.Among gram-negative bacteria,relatively higher drug-resistance was observed in Pseudomonas aeruginosa to cefoperazone and ceftazidime,Klebsiella pneumoniae to ceftriaxone and amikacin;while in gram-positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis showed high resistance to erythromycin and penicillin.In fungi,the resistance rate of Candida Glabrata to itraconazole was 100%,and that of Candida Albicans to voriconazole was also 100%.Age of 70-85,presence of combined underlying diseases,length of hospital stay≥1 month,and venipuncture were associated with higher incidence of postoperative nosocomial infection in elderly lung cancer patients compared to those aged 65-69,without combined underlying diseases,hospitalization<1 month,and absence of venipuncture(P<0.05);multivariate Logistic analysis showed that age is 70-85 years old,presence of combined underlying diseases,venipuncture and length of hospital stay≥1 month were independent risk factors for postoperative nosocomial infection among elderly patients with lung cancer(P<0.01).Conclusion The incidence of nosocomial infection in elderly patients

关 键 词：肺癌根治术 院内感染 影响因素 预防对策 

分 类 号：R734.2[医药卫生—肿瘤]