喉癌患者术后医院感染相关因素及病原学分析

发布时间：2018-06-04 02:29

  本文选题：喉癌 + 术后　； 参考：《中华医院感染学杂志》2017年13期

【摘要】：目的探讨喉癌术后医院感染相关因素及病原学分析,以期为临床预防提供依据。方法选择2013年1月-2016年6月医院手术治疗的213例喉癌患者的临床资料进行分析;分析患者发生术后感染的相关因素、感染部位分布、病原菌分布以及病原菌耐药情况。结果 29例患者发生感染,感染率为13.6%;呼吸系统感染19例,占65.52%,术后感染患者共检出病原菌50株,其中革兰阴性菌29株占58.00%,革兰阳性菌17株占34.00%,真菌4株占8.00%;金黄色葡萄球菌对替考拉宁、万古霉素敏感;耐甲氧西林金黄色葡萄球菌对奎奴普丁/达福普汀、呋喃妥因、替考拉宁以及万古霉素敏感;粪肠球菌对哌拉西林+他唑巴坦及万古霉素敏感;铜绿假单胞菌对哌拉西林他唑巴坦敏感;肺炎克雷伯菌对亚胺培南、美罗培南敏感;大肠埃希菌对哌拉西林他唑巴坦、头孢曲松、哌拉西林耐药;年龄≥60岁、病变分期为T3期,营养支持较差,手术时间≥4h,基础疾病≥2项,接受放化疗治疗,术后预防使用抗菌药物治疗,术中出血量≥20ml,血清白蛋白≤2.5g/l的患者术后医院感染率更高。结论影响喉癌患者术后医院感染的因素较多,最常见感染部位为呼吸系统,革兰阴性菌有较高的检出率,临床应根据患者具体情况,积极预防术后感染,对感染患者及时明确病原菌及药敏结果,使用敏感抗菌药物治疗。
[Abstract]:Objective to investigate the related factors and etiology of nosocomial infection after laryngeal cancer operation, so as to provide evidence for clinical prevention. Methods the clinical data of 213 patients with laryngeal cancer treated by surgery from January 2013 to June 2016 were analyzed, and the related factors of postoperative infection, distribution of infection site, distribution of pathogenic bacteria and drug resistance of pathogenic bacteria were analyzed. Results the infection occurred in 29 patients, the infection rate was 13.60.Respiratory infection was found in 19 patients (65.52%). Among them, 29 strains were Gram-negative bacteria, 17 strains were Gram-positive bacteria, and 4 strains were fungi. Staphylococcus aureus was sensitive to teicoplanin and vancomycin. Teicoplanin and vancomycin; Enterococcus faecalis sensitive to piperacillin and vancomycin; Pseudomonas aeruginosa to piperacillin and tazobactam; Klebsiella pneumoniae to imipenem and meropenem; Escherichia coli was resistant to piperacillin tazobactam, ceftriaxone, piperacillin, age 鈮，

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