摘要
目的探讨鼻咽癌患者放射治疗中发生医院感染的危险因素,制定相应的预防控制措施。方法选取2010年1月-2012年7月鼻咽癌住院患者180例,以调查表方式记录患者在放射治疗过程中医院感染的发生情况,进而分析探讨引发医院感染的危险因素并提出相应的预防控制措施。结果住院接受放射治疗期间共有159例患者发生医院感染,感染率为88.3%,其中口腔黏膜感染占57.9%、皮肤感染占27.0%、上呼吸道感染占15.1%;放射治疗第1周时发生医院感染为主,45例占28.3%;晚期鼻咽癌患者医院感染率为92.6%,早期鼻咽癌患者医院感染率为68.8%,早期患者的感染率显著低于晚期患者,差异有统计学意义(P<0.05);口腔黏膜反应、放射野皮肤反应、体质量、血红蛋白量和白细胞总数比较,未发生医院感染患者与重度感染患者差异有统计学意义(P<0.05);共分离出病原菌496株,其中革兰阴性菌398株占80.2%,革兰阳性菌42株占8.5%,真菌56株占11.3%。结论鼻咽癌患者放射治疗中发生医院感染的危险因素主要涉及放射线对于口腔黏膜和放射野皮肤的损害,同时包括对骨髓的抑制及对机体免疫力的损害,进而导致患者抵抗力下降;因此,临床应针对以上危险因素制定相应的预防控制措施。
OBJECTIVE To explore the risk factors for nosocomial infections in the patients with nasopharyngeal carcinoma during the radiotherapy and put forward corresponding prevention measures .METHODS A total of 180 patients with nasopharyngeal carcinoma who were hospitalized from Jan 2010 to Jul 2012 were enrolled in the stud-y ,then the questionnaire was used to record the incidence of nosocomial infections during the radiotherapy ,the risk factors for the nosocomial infections were analyzed so as to put forward corresponding prevention measures . RESULTS The nosocomial infections occurred in 159 patients during the radiotherapy with the infection rate of 88 .3% ,the incidence of the oral mucosa infections was 57 .9% ,the skin infections 27 .0% ,the upper respiratory tract infections 15 .1% .There were 45 （28 .3% ） patients with nosocomial infections on the fist week of radiothera-py .The incidence of nosocomial infections was 92 .6% in the patients with advanced nasopharyngeal carcinoma , significantly higher than 68 .8% in the patients with early nasopharyngeal carcinoma ,and there was significant difference （P〈0 .05） .As compared with the oral mucosal reaction ,the radiodermatitis ,the body mass index ,the hemoglobin content ,or the total white blood cell counts ,the difference between the patients without nosocomial infections and the patients with severe nosocomial infections was significant （P〈 0 .05） .Totally 496 strains of pathogens have been isolated ,including 398 （80 .2% ） strains of gram-negative bacteria ,42 （8 .5% ） strains of gram-positive bacteria ,and 56 （11 .3% ） strains of fungi .CONCLUSION The damages of radiation to the oral mu-cosa and skin of radiation fields are mainly involved in the nosocomial infections in the patients with nasopharynge-al carcinoma during the radiotherapy ,including the suppression of bone marrow and the damage to immunity ,re-sulting in the decreased resistance of the patients .It is necessary for the hospital to develop corresponding preven-tion measures according to the risk factors .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第18期4590-4592,共3页
Chinese Journal of Nosocomiology
基金
保定市科技技术研究与发展计划基金资助项目(11ZF015)
关键词
鼻咽癌
放射治疗
医院感染
危险因素
Nasopharyngeal carcinoma
Radiotherapy
Nosocomial infection
Risk factor
