局部晚期非小细胞肺癌患者同步放化疗医院感染的病原学分析及预防

目的 探讨局部晚期非小细胞肺癌患者同步放(化)疗医院感染的病原学情况及预防对策.方法 选取2007年1月-2010年1月84例进行同步放(化)疗的局部晚期非小细胞肺癌并发医院感染的患者为研究对象,将其医院感染的发生率、病原菌分布、危险因素及临床对策进行研究.结果 84例患者中以肺部感染所占比例最高,达46.43％,其次为口咽部、胃肠道及泌尿道,分别占19.05％、15.48％及13.09％;而病原菌以革兰阴性菌为主,占47.67％,其次依次为革兰阳性菌占37.21％、真菌占15.12％;患者年龄、营养状况、合并其他基础疾病种类、有侵入性操作、住院时间≥14d、应用抗菌药物≥3种为医院感染的危险因素(P＜0.05)；所有患者经针对性的治疗后感染得到有效控制.结论 局部晚期非小细胞肺癌同步放(化)疗医院感染患者的感染部位及病原菌分布均有其特殊性,给予针对性的治疗可改善预后.

Etiology of nosocomial infections in locally advanced non-small cell lung cancer patients undergoing chemoradiotherapy and the prevention

OBJECTIVE To investigate the etiology of nosocomial infections in locally advanced non-small cell lung cancer patients who underwent chemoradiotherapy and propose prevention countermeasures.METHODS A total of 84 patients with nosocomial infections who underwent synchronous chemoradiotherapy for locally advanced non-small cell lung cancer from Jan 2007 to Jan 2010 were chosen as the research objects.The incidence of nosocomial infections,distribution of the pathogens,risk factors and clinical strategies were studied.RESULTS In the 84 patients,the rate of lung infections was the highest(46.43%),followed by the oropharynx infections(19.05%),gastrointestinal tract infections(15.48%) and urinary tract infections(13.09%);and gram-negative bacteria were dominated in the pathogens,accounting for 47.67%,followed by gram-positive bacteria(37.21%) and fungi(15.12%);the age,nutrition status,combination with other underlying diseases,invasive operation,hospital stay with more than 14 days,and the use of more than 3 antibiotics were the risk factors for nosocomial infections(P<0.05);all the cases with nosocomial infections were effectively under control after the targeted treatment.CONCLUSION The distribution of the infection sites as well as the pathogens in locally advanced non-small cell lung cancer patients who underwent chemoradiotherapy has their specificities,it is necessary to perform the targeted treatment to improve the prognosis.