鼻咽癌患者放射治疗后医院感染危险因素分析

发布时间：2018-02-14 18:31

本文关键词： 鼻咽癌放射治疗医院感染危险因素　出处：《中华医院感染学杂志》2014年18期 　论文类型：期刊论文

【摘要】：目的探讨鼻咽癌患者放射治疗中发生医院感染的危险因素,制定相应的预防控制措施。方法选取2010年1月-2012年7月鼻咽癌住院患者180例,以调查表方式记录患者在放射治疗过程中医院感染的发生情况,进而分析探讨引发医院感染的危险因素并提出相应的预防控制措施。结果住院接受放射治疗期间共有159例患者发生医院感染,感染率为88.3%,其中口腔黏膜感染占57.9%、皮肤感染占27.0%、上呼吸道感染占15.1%;放射治疗第1周时发生医院感染为主,45例占28.3%;晚期鼻咽癌患者医院感染率为92.6%,早期鼻咽癌患者医院感染率为68.8%,早期患者的感染率显著低于晚期患者,差异有统计学意义(P0.05);口腔黏膜反应、放射野皮肤反应、体质量、血红蛋白量和白细胞总数比较,未发生医院感染患者与重度感染患者差异有统计学意义(P0.05);共分离出病原菌496株,其中革兰阴性菌398株占80.2%,革兰阳性菌42株占8.5%,真菌56株占11.3%。结论鼻咽癌患者放射治疗中发生医院感染的危险因素主要涉及放射线对于口腔黏膜和放射野皮肤的损害,同时包括对骨髓的抑制及对机体免疫力的损害,进而导致患者抵抗力下降;因此,临床应针对以上危险因素制定相应的预防控制措施。
[Abstract]:Objective to investigate the risk factors of nosocomial infection in patients with nasopharyngeal carcinoma (NPC) after radiotherapy, and to establish corresponding preventive and control measures. Methods from January 2010 to July 2012, 180 patients with nasopharyngeal carcinoma were selected. The nosocomial infection was recorded by questionnaire during radiotherapy. The risk factors of nosocomial infection were analyzed and the corresponding prevention and control measures were put forward. Results there were 159 cases of nosocomial infection during radiotherapy. The infection rate was 88.3, including oral mucous membrane infection, skin infection, upper respiratory tract infection, nosocomial infection, nosocomial infection, nosocomial infection, advanced nasopharyngeal carcinoma, and early nasopharyngeal carcinoma. The nosocomial infection rate was 68.8%, and the infection rate of early patients was significantly lower than that of late patients. There were significant differences in oral mucosal reaction, radiation field skin reaction, body weight, hemoglobin content and total white blood cell count between patients with nosocomial infection and those with severe infection (P 0.05), and 496 strains of pathogenic bacteria were isolated from the patients with nosocomial infection. Among them, 398 strains of Gram-negative bacteria accounted for 80.2%, 42 strains of Gram-positive bacteria accounted for 8.5%, 56 strains of fungi accounted for 11.30.Conclusion the risk factors of nosocomial infection in patients with nasopharyngeal carcinoma after radiotherapy are mainly related to radiation damage to oral mucosa and radiation field skin. At the same time, the inhibition of bone marrow and the damage of body immunity lead to the decrease of patient's resistance. Therefore, the prevention and control measures should be made for the above risk factors in clinic.
【作者单位】：河北大学附属医院肿瘤内科;河北大学附属医院功能科;
【基金】：保定市科技技术研究与发展计划基金资助项目(11ZF015)
【分类号】：R739.63

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