摘要
目的:探讨肺癌患者医院感染的特点与危险因素及其对预后的影响。方法:回顾调查我院1 280例肺癌的患者临床资料,对医院感染各种危险因素分别进行单因素和多因素分析。结果:1 280例肺癌出院病例中,98例(7.7%)发生医院感染,感染部位依次为呼吸系(73.5%)、胃肠系(11.2%)和泌尿系(8.2%)等。医院感染的病原菌多为耐药的条件致病菌和真菌,以革兰氏阴性菌为主,占56.7%,真菌占23.0%。医院感染与年龄(P=0.033)、临床分期(P=0.001)、PS评分(P=0.015)、侵入性操作(P=0.000)、手术(P=0.029)、放疗(P=0.022)、化疗(P=0.001)、贫血(P=0.000)、中性粒细胞减少(P=0.000)、使用抗生素(P=0.035)、使用激素(P=0.000)、血清白蛋白降低(P=0.000)、合并糖尿病(P=0.019)以及住院时间(P=0.000)密切相关。Logistic多因素分析显示,临床分期(P=0.024)、PS评分(P=0.012)、侵入性操作(P=0.000)、化疗(P=0.000)、贫血(P=0.036)、中性粒细胞减少(P=0.001)和住院时间(P=0.000)是肺癌患者发生医院感染的独立危险因素。医院感染不但延长患者的住院时间,还增加患者的病死率。结论:肺癌患者是医院感染的高危人群,医院感染是多种因素共同作用的结果;控制感染的危险因素,规范抗肿瘤治疗,提高机体免疫力是防控肺癌患者医院感染的主要措施。
OBJECTIVE：To investigate and evaluate the char acters and influences of nosocomial infection and related risk factors on prognosis among the lung cancer patients. METHODS： Retro spectively investigate and statistically analysis 1 280 patients with lung cancer in our hospital. Clinical data were collected and retro spectively analyzed with univariate and multivariate analysis. RE SULTS： Among 1 280 cases, the nosocomial infection rate in this co hort was 7.7% with 98 patients. The most common infection site was respiratory （73. 5%）, followed by gastrointestinal （11.2%） and urinary tracts （8.2 %）. The common pathogens in lung cancer patients with nosocomial infection were opportunistic pathogens and fungi, included 56.7% Gstrain and 23.0% fungi. Statistically a nalysis confirmed that the nosocomial infection rate was obviously related with age （P=0. 033）, clinical stage （P=0. 001）, PS score （P=0. 015）, invasive procedure （P= 0. 000）, surgery （P= 0. 029）, radiotherapy （P=0. 022）, chemotherapy （P=0. 001）, a nemia （P = 0. 000）, leukopenia （P = 0. 000）, antibiotics （P = 0. 035）, hormone （P=0. 000）, lower albumin （P=0. 000）, diabe tes （P=0. 019） and hospital stay （P=0. 000）. Clinical stage （P= 0. 024）, PS score （P = 0. 012）, invasive procedure （P =0. 000）, chemotherapy （P=0. 000）, anemia （P=0. 036）, leukopenia （P= 0. 001） and hospital stay （P=0. 000） were the independent prog nostic factors. Nosocomial infection prolonged the hospital stay and increased the mortality. CONCLUSIONS： Lung cancer may lead to nosocomial infection with the interaction of a variety of factors. It is necessary to enhance the controlling management of nosocomial in fection and antitumor treatment, decrease hormone and antibiotics application, avoid invasive procedure, enhance supporting treat ment, correct anemia and lower albumin to decrease the nosocomial infection incidence.
出处
《中华肿瘤防治杂志》
CAS
2011年第9期651-654,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
肺肿瘤
医院感染
危险因素
防控措施
lung neoplasms
nosocomial infection
risk factors
prevention and control measures
