肺癌患者病理分型及术后院内感染病原学特点分析  

Analysis of pathological types of lung cancer patients and etiological characteristics of postoperative nosocomial infections

作　　者：崔莹 崔佳 薛锐泽 刘待见[2] CUI Ying;CUI Jia;XUE Ruize;LIU Daijian(Zhengzhou Health Vocational College,Zhengzhou 450000,China;Department of Respiratory Medicine,the Second Affliated Hospital of Zhengzhou University)

机构地区：[1]郑州卫生健康职业学院,河南郑州450000 [2]郑州大学第二附属医院呼吸内科

出　　处：《中国病原生物学杂志》2025年第3期373-377,共5页Journal of Pathogen Biology

摘　　要：目的分析肺癌患者病理分型与术后院内感染病原学特点,以期为临床制定针对性预防措施提供科学依据,降低术后院内感染的发生率,提高患者的生存质量。方法选取本院2021年4月~2024年4月收治的117例肺癌术后并发院内感染患者为本次研究对象,分析患者病原菌分布特点及肺炎克雷伯菌的耐药性。依据病理分型将患者分为腺癌组、鳞癌组和小细胞肺癌组,对比分析不同病理分型患者性别、年龄分布特点及血清肿瘤标志物水平变化情况。结果在117例院内感染患者中,腺癌占44.44%,鳞癌占32.48%,小细胞癌占23.08%。腺癌患者中,女性占55.77%,鳞癌患者中,男性占78.95%,小细胞癌患者中,男性占59.26%。性别比例在不同肺癌病理分型中存在显著差异(P<0.05)。腺癌患者中,60~岁年龄段占比最高,为59.62%;鳞癌患者中,50~岁年龄段最多,占36.84%;小细胞癌患者中,50~岁年龄段最多,占37.04%。不同肺癌病理分型患者的年龄分布存在显著差异(P<0.05)。在117例患者中,82例患有呼吸系统感染,占70.09%;23例患有泌尿系统感染,占19.66%;10例患有口咽部感染,占8.55%;2例患有消化系统感染,占1.71%。共检出122株病原菌,其中革兰阴性菌80株,占65.57%;革兰阳性菌24株,占19.67%;真菌18株,占14.75%。在革兰阴性菌中,肺炎克雷伯菌22株,占比最高;其次是铜绿假单胞菌15株,流感嗜血杆菌13株,大肠埃希菌9株,鲍曼不动杆菌和嗜麦芽单胞菌各7株,阴沟肠杆菌5株,卡他莫拉菌2株。革兰阳性菌中,肺炎链球菌10株,金黄色葡萄球菌7株,表皮葡萄球菌5株,屎肠球菌2株。真菌中,白色假丝酵母菌10株,黄曲霉5株,曲霉素3株。肺炎克雷伯菌对氨苄西林、哌拉西林、头孢替坦、氨曲南、庆大霉素的耐药率高于60%,对头孢吡肟、头孢哌酮/舒巴坦、亚胺培南、美罗培南、阿米卡星的耐药率低于30%。腺癌组患者血清CEA、SCC、NSE、CYFRA21-1水平分别为(13.Objective The pathological types of lung cancer patients and the etiological characteristics of postoperative nosocomial infections were analyzed,in order to provide a scientific basis for formulating targeted preventive measures in clinical practice,reduce the incidence of postoperative nosocomial infections,and improve the quality of life of patients.Methods A total of 117 lung cancer patients with postoperative nosocomial infections admitted to our hospital from April 2021 to April 2024 were selected as the research objects in this study.The distribution characteristics of pathogenic bacteria and the drug resistance of Klebsiella pneumoniae in these patients were analyzed.According to pathological types,the patients were divided into adenocarcinoma group,squamous cell carcinoma group and small cell lung cancer group.The gender and age distribution characteristics and changes in serum tumor marker levels of patients with different pathological types were compared and analyzed.ResultsAmong the 117 nosocomial infection patients,adenocarcinoma accounted for 44.44%,squamous cell carcinoma accounted for 32.48%,and small cell carcinoma accounted for 23.08%.Among adenocarcinoma patients,females accounted for 55.77%.Among squamous cell carcinoma patients,males accounted for 78.95%.Among small cell carcinoma patients,males accounted for 59.26%.There was a significant difference in gender ratio among different pathological types of lung cancer(P<0.05).Among adenocarcinoma patients,the age group of>60 years old accounts for the highest proportion,which was 59.62%.Among squamous cell carcinoma patients,the age group of>50 years old was the most,accounting for 36.84%.Among small cell carcinoma patients,the age group of>50 years old was the most,accounting for 37.04%.There were significant differences in the age distribution of patients with different pathological types of lung cancer(P<0.05).Among the 117 patients,82 had respiratory system infections,accounting for 70.09%;23 had urinary system infections,accounting for 19.6

关 键 词：肺癌 病理分型 院内感染 肿瘤标志物 

分 类 号：R73[医药卫生—肿瘤]