鼻咽癌患者放疗期医院感染的危险因素分析及预防对策

发布时间：2018-04-10 17:28

本文选题：鼻咽癌 + 放疗　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的探究鼻咽癌患者放疗期间医院感染的危险因素并依据患者医院感染的相关危险因素采取相应的预防对策。方法选择2013年1月-2015年10月医院收治200例经病理诊断确诊的鼻咽癌患者为研究对象,分析患者感染的致病菌分布,并对其发生医院感染的相关因素进行单因素及多因素分析,其中多因素分析采用logistic回归分析。结果 200例鼻咽癌患者中,放射治疗后共157例患者发生医院感染,感染率为78.5%;患者感染部位中主要以口腔感染为主占64.3%;感染患者共分离出病原菌184株,而病原菌中主要以真菌为主127株占69.0%,革兰阴性菌40株占21.7%,革兰阳性菌17株占9.3%;多因素logistic回归分析显示,患者年龄≥60岁,常规放疗、同步化疗、相关侵入性操作、肿瘤分期高、抗菌药物≥2种以及免疫抑制剂使用情况是鼻咽癌患者放疗期发生医院感染的独立危险因素(P0.05)。结论鼻咽癌患者在医院治疗期部分患者因发生感染,对其治疗和预后有着严重影响,因此详细了解鼻咽癌患者放疗期医院感染的好发部位、病原菌种类以及导致感染的相关危险因素,对于指导临床依据病原菌分布和其耐药情况给予合理抗菌药物治疗有着重要意义;同时依据导致患者发生医院感染的危险因素进行预防,可在一定程度上降低医院感染率的发生,值得临床推广。
[Abstract]:Objective to investigate the risk factors of nosocomial infection in patients with nasopharyngeal carcinoma (NPC) during radiotherapy and to take corresponding preventive measures according to the related risk factors of nosocomial infection.Methods from January 2013 to October 2015, 200 patients with nasopharyngeal carcinoma (NPC) diagnosed by pathological diagnosis were selected as study subjects. The distribution of pathogenic bacteria was analyzed, and the related factors of nosocomial infection were analyzed by univariate and multivariate analysis.Logistic regression analysis was used for multivariate analysis.Results among the 200 patients with nasopharyngeal carcinoma, 157 patients developed nosocomial infection after radiotherapy, the infection rate was 78.5%, the main infection site was oral infection (64.3%), and 184 strains of pathogenic bacteria were isolated from the infected patients.Among the pathogens, 127 strains were mainly fungi, 40 Gram-negative bacteria accounted for 21.7 and 17 Gram-positive bacteria accounted for 9.3.The multivariate logistic regression analysis showed that the patients were aged more than 60 years, conventional radiotherapy, synchronous chemotherapy, related invasive operation and high tumor stage.Two or more antimicrobial agents and the use of immunosuppressants were independent risk factors for nosocomial infection in patients with nasopharyngeal carcinoma during radiotherapy.Conclusion the infection in part of patients with nasopharyngeal carcinoma during the period of hospital treatment has a serious effect on the treatment and prognosis. Therefore, the location of nosocomial infection in patients with nasopharyngeal carcinoma during radiotherapy is understood in detail.The types of pathogenic bacteria and the related risk factors of infection are of great significance in guiding the rational treatment of antibiotics according to the distribution of pathogens and their drug resistance.At the same time, according to the risk factors of nosocomial infection, the nosocomial infection rate can be reduced to a certain extent, which is worthy of clinical promotion.
【作者单位】：湖北医药学院附属随州医院肿瘤放疗科;湖北医药学院附属随州医院急诊医学科;湖北医药学院附属随州医院耳鼻喉科;
【基金】：湖北省卫计委面上基金资助项目(JX6B128)
【分类号】：R730.55;R739.63

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