放疗加紫杉醇治疗晚期鼻咽癌患者医院感染的临床分析

Nosocomial Infection During Radiotherapy with Concomitant Weekly Paclitaxel for Advanced Nasopharyngeal Carcinoma: A Clinical Investigation

目的调查分析晚期鼻咽癌患者常规放疗同时行紫杉醇化疗过程中并发医院感染及相关因素,探讨有效的防治措施。方法对我院26例行放疗同时紫杉醇化疗鼻咽癌住院患者发生医院感染及危险因素进行回顾性分析。结果26例住院患者发生医院感染20例,占76.9%;检出致病菌26株,其中以白色念珠菌为主,占46.2%,革兰阴性菌占38.5%,革兰阳性菌占11.5%;鼻咽癌放疗、化疗同步治疗并发医院感染与长期住院、口腔黏膜损伤、白细胞下降、不合理应用抗生素和糖皮质激素等因素有关。结论缩短平均住院日、加强口腔护理、预防白细胞下降、合理应用抗生素和糖皮质激素,以减少鼻咽癌同步放化疗患者医院感染的发生率。

OBJECTIVE To investigate the risk factors of nosocomial infection in patients with advanced nasopharyngeal cancer during radiotherapy with concomitant weekly paclitaxel treatment. METHODS Twenty six cases of advanced nasopharyngeal cancer patients in our hospital were analyzed retrospectively. RESULTS There were 20 cases of nosocomial infection from inpatients. The infection rate was 76.9 % and isolates of bacteria were found, of which Candida albicans accounted for 46.2%, Gram-negatives were 38.5%, Gram-positives were 11.5%. The main risk factors were long time hospitalization, oral mucosal lesion, leukocytopenia, improper application of antibiotic and glucocorticoids. CONCLUSIONS To prevent and control nosocomial infection in advanced nasopharyngeal cancer during radiotherapy and concomitant chemotherapy, measures such as shortening hospitalization days, reinforcing oral nursing, preventing the leukocytopenia, reasonable using of antibiotics and glucocorticoids should be adopted.