Logistic回归分析恶性肿瘤患者并发医院感染的特点

Analysis of Factors Influencing Nosocomial Infection in Patients With Malignant Tumor by Using Logistic Regression

目的探讨恶性肿瘤患者并发医院感染的特点及其危险因素。方法回顾性分析210例恶性肿瘤并发医院感染的患者的临床资料,对可能与恶性肿瘤并发医院感染有关的因素进行非条件Logistic回归分析。结果恶性肿瘤患者医院感染率高于其他疾病患者(P<0.05),且并发医院感染以肺癌病人为主。常见的感染部位为呼吸道、泌尿道和胃肠道,病原菌以革兰阴性杆菌为主(56.3%)其中以大肠埃希菌、铜绿假单胞菌及肺炎杆菌为主。多因素非条件Logis-tic回归分析筛选出住院的时间、介入性操作、抗生素的应用、化疗、手术、合并糖尿病及肿瘤转移是医院感染的危险因素(P<0.05)。结论为了预防恶性肿瘤患者发生医院感染,应采取的主要措施是缩短住院时间、合理使用抗生素、尽量避免化疗导致的白细胞下降、减少不必要的介入性操作、严格的控制原发病。

Objective To investigate the characters and risk factors of nosocomial infection among the patients with malignant tumor. Methods Retrospective review of 210 patients with malignant tumor associated nosocomial infection, and the affecting factors were analyzed by Logistic regression method. Results The nosocomial infection rate in patients with malignant tumors was higher than that in patients with other diseases, and nosocomial infection occurred mainly in patients with lung cancer. The respiratory tract was the most frequent infection site, followed by urinary and gastrointestinal tract. The common pathogen was Gram- negative bacilli （56.3%） and the bacilli were mainly Escherichia coli, Pseudornonas aeruginosa and Pneumonia bacilli. Multiple factor unconditional Logistic regression screened out that the relative factors were the duration in hospital, all kinds of invasive procedures, antibiotic application, chemotherapy, surgery, and complicated with diabetes and/or metastasis （P〈0.05）. Conclusions Reduction of hospital stay, rational use of antibiotics, prevention neutropenia after chemotherapy, strengthening resistance, increasing the nursing care quality, decreasing unnecessary invasive procedures and strict control of hyperglycemia among patients with malignant tumor with co- morbidities are important measures to decrease their nosocomial infections.