中晚期原发性肝癌患者医院感染分析及对策

Hospital Infection Analysis and Countermeasure for Primary Liver Cancer Patients During Medium and Advanced Stage

目的探讨中晚期原发性肝癌患者医院感染危险因素并提出预防措施。方法对2001-2006年中晚期肝癌住院患者进行回顾性调查、分析、总结。结果中晚期肝癌医院感染率为33.92%;感染部位以肺部、腹腔、肠道、血液多见;感染组病死率20.83%,非感染组病死率10.16%,两组间病死率差异有统计学意义(P<0.05);贫血组感染率41.57%,无贫血组的感染率21.65%,贫血组感染率高于非贫血组,差异有统计学意义(P<0.01);白细胞下降组的医院感染率42.86%,无下降组的医院感染率为22.47%,白细胞下降组的医院感染率高于无下降组,差异有统计学意义(P<0.01);随着住院时间延长感染发生率逐步增加,病原菌以G-菌为主。结论中晚期肝癌有着较高的医院感染发生率和死亡率,其发生与贫血、白细胞减少及住院时间有关,护理人员应明确预防感染的重要性,加强中晚期肝癌患者预防感染措施。

OBJECTIVE To discuss risk factors of hospital infection in patients who suffered from primary cancer of the liver in the medium and advanced stage and give the countermeasures. METHODS The liver cancer cases in medium and advanced stage in 2001--2006 were retrospectively investigated and analyzed. RESULTS The hospital infection rate was 33.92% for the liver cancer patients who were in the medium and advanced period; the more common sites of infection were lungs, abdominal cavity, intestinal tract, blood. The motality was 20.83% in the infection group and 10.16 % in non-infection group and there were significant differences between two groups （P〈 0.05）. The infection rate was 41.57% in anemia group and 21.65% in non-anemia group, the infection rate of anemia group was higher than that in non-anemia group （P〈0.01）. The hopital infection rate was 42.86% in leukopenia descends group and 22.47% in non-leukopenia group. The rate of hospital infection in former group was higher than that in letter group （P〈0. 01）, The infection rate after long hospitalization was increased gradually. The main pathogen was Gram-negatives. CONCLUSIONS The liver cancer during medium and advanced period shows higher hospital infection occurrence rate and mortality rate, which related to anemia, leukopenia and long hospitalization. Nursing staff should be noted the importance of hospital infection, and the precautions for hospital infection to the liver cancer in the medium and advanced period should be strengthened.