老年恶性肿瘤患者院内感染临床分析

目的：探讨老年肿瘤患者院内感染的易感因素及治疗对策。方法：对我科1998年1月～2002年1月126例院内感染的部位、易感因素及感染菌种等情况作回顾性总结分析。结果：发生院内感染的126例患者，占同期收住的老年恶性肿瘤患者的10．68％，死于感染的占感染人数的20．63％。感染部位以呼吸道为首位（50．00％），其次为胃肠道（18．25％）。各种原因引发的骨髓抑制及慢性衰竭、长期卧床是本组病例的常见感染因素，白细胞总数低下者感染率明显高于白细胞正常者（P〈0．05）。细菌学检查检出菌株排列前3位的为白色念珠菌、铜绿假单胞菌和表皮葡萄球菌，且对抗生素有较高的耐药性。结论：老年恶性肿瘤患者院内感染机率较高，化学治疗、放射治疗、慢性衰竭、长期卧床患者均较易发生院内感染，尤其要警惕真菌感染的发生。一旦确诊，尽早足量使用抗感染药物。

Clinical analysis of infection in hospital of elderly cancer patients

Objective:To investigate the susceptible factors and treatment against cross infection in hospital of elderly cancer patients.Methods:126 cases of cross infection in hospital of cancer patients from 1998 to 2002 were analyzed for infective site,infective agent and infectious bacteria.Results:126 cases of cross infection in hospital of elderly cancer patients were found,which was 10.68% of the in-patients of the same period. Of 126 cases, there were 20.63% died of infection. Respiratory tract infection rate was 50%,gastrointestinal was 18.25%. Bone marrow depression or chronic failure and long-term decubitus were common causes of infection. The infection rate in patients with leukopenia is significantly higher than that in patients with normal leukocyte count(P<0.05). The first three strain from sputum culture are candida albicans, pseudomonas aeruginosa, staphylococci epidermides, and those bacteria have resistance to antibacteria.Conclusion:Cross infection in the hospital occurs that patients enfeebled by chemotherapy, radiotherapy, chronic bone marrow failure and long-term dewubitus. Attention should be paid to the possibility of mycotic cross-infection in hospitals, as the prognosis could be quite serious. As soon as the diagnosis is confirmed, early and full dose treatment by anti-mycotic drugs should be given.