大肠癌术后中心静脉导管真菌感染相关因素分析

目的：探讨大肠癌患者术后中心静脉导管（CVC）真菌感染的相关因素，寻求有效的预防改进措施。方法：回顾性分析100例住院的大肠癌手术患者（手术组）留置CVC的感染情况，并分析感染的相关因素。与同时期62例术后化疗患者（化疗组）留置CVC的感染情况进行比较。结果：手术组中7例（7．00％）发生CVC相关性真菌感染，其中6例单纯CVC感染，1例同时合并真菌血症。7例患者均为念珠菌感染，主要为近平滑念珠菌57．1％（4／7）。其感染与术后并发吻合口瘘有关，而与患者年龄、性别、手术方式、肿瘤大小、分期、导管留置时间和置管位置无关。6例患者拔除CVC后感染自愈，1例真菌血症患者抗真菌治疗后痊愈。化疗组没有患者发生导管相关真菌感染，与手术组感染率相比差异有统计学意义，P〈10．05。结论：大肠癌手术后CVC相关真菌感染的主要病原菌是近平滑念珠菌，吻合口瘘可能是其高危因素，及时拔除感染的CVC，可有效地防治导管相关的血行感染。

Analysis of risk factors associated with central vein catheter-related infection of fungous in post-operation patients with colorectal cancer

OBJECTIVE To explore the incidence,etiology and risk factor of central venous catheter related （CVC） fungous infection in patients with eolorectal cancer and proposes the preventive measures. METHODS： A retrospective a- nalysis was performed on 100 （CVC） related infection patients in post-operation with colorectal cancer（operation-group）, and compared with simultaneous 62 patients CVC treated chemotherapy after operation （chemotherapy-group）. RE- SULTS： In operation-group CVC related fungous infection accounted for 7.00% （7 cases）. In the 7 patients there were simple CVC-RI 6 cases and combined fungemia 1 cases. All of the 7 patients were Monilia in which Candida parapsilosis accounted for 57.1% （4/7）. The infection was possibly associated with anastomosis fistulae but not associated with the age,sex,modus operandi,size and staging of the tumor,time and location of the catheter. Six cases cured after pulling out the catheter,1 cases combined fungemia treated with antifungal. No patient suffered from CVC related fungous infection in chemotherapy-group. The rate of infection between two group shown significantly statistical difference （P~O. 05）. CONCLUSIONS： The most common CVC related fungous are Candida parapsilosis in operation patients with colorectal cancer. Anastomosis fistulae is the possible risk factor of CVC related fungous infection,and removing CVC in time is an effective measure for prevention CVC related fungemia.