老年肺癌患者化疗后肺部感染危险因素分析

目的 探讨老年肺癌患者化疗后发生肺部感染的相关危险因素.方法 回顾性分析医院2003年1月-2010年10月收治的进行化疗的老年肺癌患者504例,对在化疗期间发生肺部感染的87例患者进行分析,提出干预措施.结果 504例老年肺癌化疗患者,发生肺部感染87例,感染率为17.3％,因感染死亡3例,死亡率为0.6％；患者多为复合感染,克雷伯菌属占29.9％,假单胞菌属占27.6％,葡萄球菌属占25.3％,真菌占17.2％；患者高龄与肺部感染的发生有关,60～65、65～70、70～75岁感染发生率分别为7.0％、18.1％、35.4％；行两种药物联合化疗230例,占45.6％,单种药物化疗274例,占54.4％,其感染发生率比较,差异有统计学意义(P＜0.05)；白蛋白＜30 g/L者285例占56.5％、≥30 g/L者219例占43.5％,差异有统计学意义(P＜0.05).结论 老年肺癌患者在化疗期间易发生肺部感染,其相关因素为医院内菌群,年龄、化疗剂量、患者营养状态、化疗后血像、KPS评分有相关性.

Risk factors for pulmonary infections in elderly lung cancer patients after chemotherapy

OBJECTIVE To explore the risk factors for pulmonary infections in the elderly lung cancer patients after chemotherapy.METHODS We retrospectively analyzed 504 elderly lung cancer patients who received chemotherapy from Jan 2003 to Oct 2010,and the pulmonary infections that occurred in 87 patients during the chemotherapy were analyzed,the intervention measures were proposed.RESULTS Of 504 elderly lung cancer patients who underwent chemotherapy,there were 87 cases(17.3%) with pulmonary infections.3 cases died due to the infections with the death rate of 0.6%;most of the patients were with multiplicity of infections,Klebsiella,Pseudomonas,Staphylococcus,and fungi accounted for 29.9%,27.6%,25.3%,and 17.2%,respectively;the age of the elderly patients was related to the pulmonary infections,the incidence rates of the pulmonary infections in the patients of 60-65 years of age,65-70 years of age,and 70-75 years of age were 7.0%,18.1%,and 35.4%,respectively;there were 230(45.6%) patients who underwent chemotherapy with two-drug and 274(54.4%) patients who underwent chemotherapy with one-drug,the difference in the incidence rate of infections was statistically significant(P<0.05);there were 285(56.5%) patients with the protein content <30 g/L and 219(43.5%) patients with the protein content ≥30 g/L,the difference was statistically significant(P<0.005).CONCLUSION The elderly patients with lung cancer are prone to pulmonary infections during the chemotherapy,which are associated with the bacterial flora,ages,chemotherapeutic doses,nutritional state,blood after chemo,and KPS.