老年肺癌患者术后发生院内肺部感染的危险因素及病原菌分布  

Risk Factors and Distribution of Pathogenic Bacteria for Nosocomial Lung Infection Occurred in Elderly Lung Cancer Patients after Surgery

作　　者：林志明 史文武 黎海霞[1] 郭华[1] LIN Zhiming;SHI Wenwu;LI Haixia;GUO Hua(Chinese People's Liberation Army Joint Logistic Support Force Lushan Rehabilitation and Recuperation Center,Jiujiang 332000,China;不详)

机构地区：[1]中国人民解放军联勤保障部队庐山康复疗养中心,江西九江332000

出　　处：《中国医学创新》2023年第29期160-165,共6页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202311648)。

摘　　要：目的:探讨老年肺癌患者术后发生院内肺部感染的危险因素及病原菌分布。方法:选取2020年4月—2022年4月中国人民解放军联勤保障部队庐山康复疗养中心收治的100例老年肺癌患者,均接受手术治疗。术后观察患者有无肺部感染,分析肺部感染的危险因素,并采集患者痰标本进行细菌培养,分析病原菌分布。结果:在100例老年肺癌患者中,术后发生院内肺部感染25例,感染率为25.00%。两组年龄、吸烟史、慢性阻塞性肺疾病、开胸手术、手术耗时、机械通气时间、胸腔引流时间、术后动脉血氧分压(PaO_(2))和血清白蛋白比较,差异均有统计学意义(P<0.05)。年龄、术后PaO_(2)<90%、血清白蛋白<35 g/L是影响老年肺癌患者术后发生院内肺部感染的独立危险因素(P<0.05)。25例院内肺部感染患者中,痰培养出41株病原菌,其中革兰阴性菌23株,以大肠埃希菌为主;革兰阳性菌13株,以金黄色葡萄球菌、肺炎链球菌为主;真菌5株。结论:老年肺癌患者术后院内肺部感染发生率较高,危险因素较多,其中患者年龄、术后PaO_(2)、血清白蛋白是影响老年肺癌患者术后发生院内肺部感染的独立危险因素,病原菌多为革兰阴性菌感染。Objective:To investigate the risk factors and distribution of pathogenic bacteria for nosocomial lung infections occurred in elderly lung cancer patients after surgery.Method:A total of 100 elderly lung cancer patients admitted to Chinese People's Liberation Army Joint Logistic Support Force Lushan Rehabilitation and Recuperation Center from April 2020 to April 2022 were selected,all of them received surgery treatment.After surgery,the patients were observed for lung infection,the risk factors of lung infection were analyzed,and sputum samples were collected for bacterial culture to analyze the distribution of pathogenic bacteria.Result:Among the 100 elderly patients with lung cancer,25 patients had nosocomial lung infection after surgery,with an infection rate of 25.00%.There were statistically significant differences in age,smoking history,chronic obstructive pulmonary disease,thoracotomy,operation time,mechanical ventilation time,thoracic drainage time,postoperative partial oxygen pressure(PaO_(2))and serum albumin between the two groups(P<0.05).Age,postoperative PaO_(2)<90% and serum albumin<35 g/L were independent risk factors for postoperative nosocomial lung infection occurred in elderly patients with lung cancer(P<0.05).Among 25 patients with nosocomial lung infection,41 strains of pathogenic bacteria were cultured in sputum,including 23 strains of gram-negative bacteria,mainly Escherichia coli,13 strains of gram-positive bacteria,mainly Staphylococcus aureus and Streptococcus pneumoniae,and 5 strains of fungi.Conclusion:The incidence of nosocomial lung infection in elderly patients with lung cancer after surgery is high,and there are many risk factors.Among them,the patient's age,postoperative PaO_(2),and serum albumin are independent risk factors affecting the incidence of nosocomial lung infection in elderly patients with lung cancer after surgery,and the pathogenic bacteria are mostly Gram-negative bacterial infection.

关 键 词：肺癌 肺部感染 老年 危险因素 病原菌 

分 类 号：R734.2[医药卫生—肿瘤]