恶性肿瘤患者医院感染120例临床分析

目的探讨恶性肿瘤患者粒细胞缺乏期发生医院感染的特点及防治对策。方法回顾性分析我院1997年1月～2003年12月收治的120例恶性肿瘤患者化疗后粒细胞缺乏期医院感染发生的特点，分析感染发生的因素及感染种类等以及治疗效果。结果发生院内感染的恶性肿瘤患者中，急性白血病患者、肺癌为主(70／120)。感染部位以呼吸道感染最多．占78．89％，其次是口腔粘膜、胃肠道、皮肤及腹腔等。感染种类以细菌为主，真菌感染有明显上升趋势。导致感染的病原菌主要为G-菌，对美罗培南、亚胺培南／两司他丁较敏感。结论恶性肿瘤患者院内感染机率较高，作好基础护理，肠道消毒及粒细胞刺激因子等，合理使用抗生素，警惕真菌感染等是预防和治疗恶性肿瘤患者医院感染的重要措施。

Clinical analysis of 120 cases of malignancies with nosocomial infections]

OBJECTIVE: To explore the clinical features and treatment of nosocomial infections in patients with malignancies in the period of agranulocytosis following chemotherapy. METHODS: The clinical features of hospital-acquired infections were reviewed and analyzed in 120 patients with malignancies in state of agranulocytosis after chemotherapy. The infection-related factors, classification of the pathogens and therapeutic effect were also analyzed. RESULTS: The hospital-acquired infections involved mostly patients with acute leukemia and lung cancer (70/120), occurring at the site of the respiratory tract (78.89%), oral mucosa, gastrointestinal tract, skin and abdominal cavity, etc. The pathogens responsible for the infection are mainly bacteria, with increased incidence of mycotic infections. The pathogenic bacteria causing the infections were predominately G-bacterium, which were sensitive to meropenem and imipenem/cilastatin. CONCLUSION: Patients with malignancies are at high risk of hospital-acquired infection. Good basic nursing care, intestinal tract disinfection, application of granulocyte-stimulating factors, adequate use of antibiotics and constant vigilance of mycotic infection are the key measures to prevent and treat these nosocomial infections.