老年食管癌术后肺部感染病原菌分布、耐药性分析及危险因素探讨  

Analysis of distribution of pathogenic bacteria,drug resistance,and risk factors of lung infection in elderly patients with esophageal cancer after surgery

作　　者：文方[1] 冯缘[1] 赵文君[1] WEN Fang;FENG Yuan;ZHAO Wen-jun(Endoscopy Center,Mianyang Central Hospital,Mianyang 621000, China)

机构地区：[1]四川省绵阳市中心医院内镜中心,四川绵阳621000

出　　处：《实用医院临床杂志》2021年第5期100-103,共4页Practical Journal of Clinical Medicine

基　　金：四川省医学会科研基金资助项目(编号S18032)。

摘　　要：目的分析影响老年食管癌术后肺部感染病原菌分布、耐药性及危险因素。方法选取2019年5月至2020年5月我院收治的93例经手术治疗的食管癌患者,结合患者术后肺部感染情况、病原菌分布、药敏试验结果,分析患者术后肺部感染的危险因素。结果本组20例患者发生肺部感染,感染率21.51%;金黄色葡萄球菌耐药率排名中苯唑西林(83.33%)、青霉素(66.67%)较高;肺炎链球菌耐药率排名中青霉素(100.00%)、苯唑西林、庆大霉素(75.00%)较高;铜绿假单胞菌耐药率排名中哌拉西林(100.00%)、氨苄西林、头孢唑林(87.50%)、氨曲南(75.00%)较高;肺炎克雷伯菌耐药率排名中氨苄西林(83.33%)、哌拉西林、头孢唑林(66.67%)较高。患者年龄≥65岁、合并糖尿病及COPD、手术时间≥4 h、有喉返神经损伤为食管癌患者术后发生肺部感染的独立危险因素(P<0.05)。结论根据食管癌患者术后肺部感染病原菌分布、耐药性及影响肺部感染的危险因素及时采取合理手段进行干预,可有效降低患者术后肺部感染概率发生。Objective To investigate and analyze the distribution of pathogenic bacteria,drug resistance and risk factors that affect lung infection after esophageal cancer surgery in the elderly.Methods Clinical data of 93 patients with esophageal cancer treated with surgery in our hospital from May 2019 to May 2020 were selected.The postoperative lung infection,pathogen distribution,and results of drug sensitivity test were combined to analyze the risk factors of postoperative lung infection.Results Among patients with esophageal cancer,20 patients developed lung infections,and infection rate was 21.51%.According to the resistance rate of Staphylococcus aureus,oxacillin(83.33%)and penicillin(66.67%)were higher.According to the resistance rate of Streptococcus pneumoniae,penicillin(100.00%),oxacillin(83.33%),and gentamicin(75.00%)had higher rank.According to the drug resistance rate of and Pseudomonas aeruginosa,piperacillin(100.00%),ampicillin(83.33%),cefazolin(87.50%),and aztreonam(75.00%)were higher.According to the resistance rate of Klebsiella pneumoniae,ampicillin(83.33%),piperacillin,and cefazolin(66.67%)were higher.The analysis of unconditional multivariate logistic regression model showed that the age of patients≥65 years old,diabetes,chronic obstructive pulmoriary disease(COPD),operation time≥4 h,and recurrent laryngeal nerve injury were independent risk factors for postoperative lung infection in patients with esophageal cancer(P<0.05).Conclusion According to the distribution of pathogenic bacteria,drug resistance and risk factors of lung infection in patients with esophageal cancer after surgery,reasonable measures should be taken in time to intervene.Thus,it can effectively reduce the probability of postoperative lung infection in the patients.

关 键 词：食管癌 肺部感染 病原菌 耐药性 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]