摘要
目的了解死亡肿瘤患者发生医院感染的基本情况,探讨死亡原因与感染的关系。方法回顾性调查分析医院2004-2005年309份死亡病历。结果309例死亡病例中,医院感染64例、72例次,医院感染率为20.71%、例次感染率为23.30%,是同期医院总感染率的5.85倍,其中48例医院感染直接与死亡有关,占医院感染死亡的75.00%;64例有医院感染的死亡病例平均住院63.94 d,比全院平均住院日(29.21 d)多34.73 d;与免疫功能有关的肿瘤医院感染率较其他肿瘤高(P<0.01);既往曾行放疗和化疗的患者,其医院感染的发生率明显高于未行放疗、化疗者(P<0.05);下呼吸道感染占医院感染的首位;在送检的57份各类标本中检出真菌18株、G-杆菌13株、G+球菌11株。结论医院感染是加速和导致肿瘤患者死亡的重要原因,呼吸系统感染是预防的重点,真菌为医院感染的主要致病菌,缩短平均住院日,加强对放、化疗后患者的支持治疗,有利于减少医院感染发生率。
OBJECTIVE To analyze the nosocomial infections among dead cases with cancer and explore the relationship between death and nosocomial infections. METHODS Totally 309 dead cases with cancer were investigated and analyzed in 2004-2005. RESULTS From them 64 with 72 times accompanied by nosocomial infections （20.71%, 23.30%）, the rate was 5. 85 times higher than the total nosocomial infection rate in the hospital. Of 64 cases with nosocomial infections, 48 （75%） were led to death directly by nosocomial infections. The average hospitalization time of these 64 dead cases with nosocomial infections was 63.94 days, which was 20.98 days longer than the whole average hospitalization time （29.21 days）. Cases with tumors related to immune system were more often accompanied by nosocomial infections than with other tumors （P〈0. 01）, same tendency could be seen in cases who had received radiotherapy and chemotherapy. Lower respiratory tract infections were most common in nosocomial infections. Of 57 detected samples, 18 were fungi strains, 13 Gram-negative bacteria, and 25 Gram-positive bacteria. CONCLUSIONS Nosocomial infection is an important reason that accelerates and leads to patients death. Respiration system infection is the focal point in prevention; fungi strains are the main nosogenesis of nosocomial infection. The nosocomial infection morbidity and mortality can be decreased by shortening hospitalization days and strengthening support treatment to cases with radiotherapy and chemotherapy.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第9期1091-1093,共3页
Chinese Journal of Nosocomiology
关键词
肿瘤
医院感染
死亡病例
Tumor
Nosocomial infection
Dead case
