宫颈癌患者近距离放疗局部感染的临床分析

发布时间：2018-06-16 12:17

本文选题：宫颈癌 + 局部感染　；参考：《中华医院感染学杂志》2015年10期

【摘要】：目的探讨宫颈癌患者近距离放疗后局部感染情况,分析阴道分泌物的病原菌分布及耐药性,为临床防治局部感染提供依据。方法选取2013年1月-2014年12月医院就诊并实施近距离放疗的356例宫颈癌患者为研究对象,调查分析患者放疗后局部感染情况、阴道分泌物病原菌分布及其耐药性。结果 356例患者中68例发生局部感染,感染率为19.1%;共分离病原菌75株,其中革兰阴性菌50株占66.7%,以大肠埃希菌和奇异变形菌为主,革兰阳性菌22株占29.3%,以葡萄球菌属和肠球菌属为主,真菌3株占4.0%,以白色假丝酵母菌为主,大肠埃希菌对头孢噻肟、头孢吡肟、头孢他啶、阿莫西林、哌拉西林、环丙沙星和庆大霉素耐药率较高,耐药率为62.5%~93.8%;奇异变形菌对阿莫西林和庆大霉素耐药率较高,耐药率为66.7%和55.6%;葡萄球菌属对青霉素G、红霉素、环丙沙星、左氧氟沙星和氨苄西林高度耐药,耐药率为53.8%~92.3%;肠球菌属对庆大霉素、红霉素和左氧氟沙星高度耐药,耐药率为66.7%~100.0%。结论宫颈癌近距离放疗合并局部感染率较高,临床应加强感染病原菌检测,掌握病原菌种类及其耐药性,指导临床合理使用抗菌药物,提高患者临床治疗效果。
[Abstract]:Objective to investigate the local infection in patients with cervical cancer after brachytherapy, and to analyze the distribution and drug resistance of vaginal secretions in order to provide evidence for clinical prevention and treatment of local infections. Methods 356 patients with cervical cancer were selected from January 2013 to December 2014 and received brachytherapy. The local infection, the distribution of pathogenic bacteria in vaginal secretions and their drug resistance were investigated and analyzed. Results Local infection occurred in 68 of 356 patients, and the infection rate was 19.1.A total of 75 strains of pathogenic bacteria were isolated, of which 50 strains were Gram-negative bacteria (66.7%), mainly Escherichia coli and Proteus mirabilis. 22 strains of Gram-positive bacteria accounted for 29.3%, mainly Staphylococcus and Enterococcus, fungi 3 strains were 4.0, mainly Candida albicans, Escherichia coli to cefotaxime, cefepime, ceftazidime, amoxicillin, piperacillin, The resistant rates of ciprofloxacin and gentamycin were higher (62.5%, 93.8%), amoxicillin and gentamicin resistance rates were higher (66.7% and 55.6%), Staphylococcus belonged to penicillin G, erythromycin, ciprofloxacin, staphylococci were resistant to penicillin G, erythromycin and ciprofloxacin, the resistance rates of Proteus mirabilis to amoxicillin and gentamycin were 66.7% and 55.6%, respectively. Levofloxacin and ampicillin were highly resistant, the resistance rate was 53.8% and 92.3%, and Enterococcus was highly resistant to gentamicin, erythromycin and levofloxacin, and the resistance rate was 66.7%. Conclusion the local infection rate of cervical cancer combined with brachytherapy is high. It is necessary to strengthen the detection of pathogenic bacteria, master the types of pathogens and their drug resistance, guide the rational use of antimicrobial agents in clinic and improve the clinical therapeutic effect.
【作者单位】：浙江省肿瘤医院妇瘤放疗科;
【基金】：浙江省医学高等专科学校科研基金资助项目(2009XZB04)
【分类号】：R737.33

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