肺癌化疗期间合并医院获得性肺炎的诊治分析

目的分析肺癌化疗期间合并医院获得性肺炎的病原菌特征，指导选择敏感的抗生素。方法回顾30例肺癌化疗期间医院获得性肺炎的细菌学资料，根据药敏选择抗生素。结果30例病例分离培养出33株病原菌，革兰氏阴性杆菌24株（72．7％），革兰氏阳性球菌7株（21．2％），真菌2株（6．1％）。亚胺培南、头孢他定、阿米卡星、头孢哌酮对31株革兰氏阴性、阳性菌敏感性分别为97％、81％、71％、68％。而氨苄青霉素、头孢呋辛、头孢唑啉的耐药性较高。结论肺癌患者化疗期间合并医院获得性肺炎的病原菌以革兰氏阴性杆菌为主，是临床合理选择抗生素的重要依据。

Diagnosis and Therapy of Nosocomial Pneumonia in Patients with Lung Cancer during Chemotherapy

OBJECTIVE To analyze the pathogenic bacteria features and the selecting sensitive antibiotics of nosocomial pneumonia in patients with lung cancer during chemotherapy.METHODS The bacteria data of 30 patients were retrospectively analyzed,to select correctly antibiotics according to the sensitivity test. RESULTS 33 strains were isolated from 30 patients,Gram-negative bacilli 24 strains(72.7%),Gram-positive cocci 7 strains(21.2%),fungi 2 strains(6.1%).The sensitivity rates of imipenem,ceftazidime,amikacine and cefoperazone were 97%,81%,71%,68% in 31 strains .Ampicillin,cefuroxime and cefazolin.CONCLUSION Gram-negative bacilli were main pathogenic bacteria in hospital acquired pneumonia patients with lung cancer during chemotherapy,these were the important base of antibactic choice.