恶性肿瘤患者侵袭性真菌感染危险因素分析

目的:研究肿瘤患者侵袭性真菌感染的危险因素和菌株分布等，为预防与治疗肿瘤患者侵袭性真菌感染提供参考依据。方法:回顾性分析2012年3月-2014年3月96例侵袭性真菌感染的肿瘤患者。96例侵袭性真菌感染的患者主要类型为肺癌32例，肝癌12例，胃癌18例，食道癌7例，胰腺癌9例，肠癌4例，白血病8例，卵巢癌3例，鼻咽癌1例，前列腺癌2例。分析研究侵袭性真菌感染的病原菌分布、高危影响因素以及与肿瘤转移的关系等。结果:住院时间长短、肿瘤早晚期、抗肿瘤药物的使用和侵袭性操作等与肿瘤患者侵袭性真菌感染有明显相关性，差异有统计学意义。侵袭性真菌感染的标本分别为痰、尿、血液、腹水、胸水，胆汁和脑脊液，各部位主要感染的侵袭性真菌为白色念珠菌，占54.8%。96例患者共20例死亡，侵袭性真菌感染的相关死亡率为20.8%，其中有45例患者发生了远处肿瘤转移，肿瘤转移患者侵袭性真菌感染在血标本中更易检出。结论:肿瘤患者放化疗后， 具有较高的侵袭性真菌感染率，并且真菌感染多发生于肿瘤转移患者。

Risk factors of invasive fungal infections in malignant tumor patients

Objective:To analyze the risk factors of invasive fungal infections,strain distribution in malignant tumor patients.Methods:Retrospectively analyze 96 malignant tumor patients with invasive fungal infection from Mar.2012 to Mar.2014,including 32 lung cancer patients,12 liver cancer patients,18 stomach cancer patients,7 esophageal cancer patients,9 pancreatic cancer patients,4 intestinal cancer patients,8 leukemia patients,3 ovarian cancer patients,1 nasopharyngeal cancer patient and 2 prostate cancer patients.To explore the risk factors of invasive fungal infections,strain distribution in malignant tumor patient.Results:The invasive fungal infections was related with the length of stay,tumor staging,antitumor therapies and operations.Specimens of infection were sputum,urine,blood,ascites,pleural effusion,bile and cerebrospinal fluid.Candida albicans is the most common fungus,accounting for 54.8%.Among the 96 patients,20 patients (20.8%) died of fungi infection,45 patients underwent cancer metastasis.Conclusion:The invasive fungal infection rate is much higher in malignant tumor patients,which is more common in metastasis disease.