晚期肺癌伴下呼吸道感染的临床分析

Clinical analysis of pulmonary infection in patients with advanced lung cancer

目的:探讨晚期肺癌患者发生肺部感染的病原菌及药敏情况。方法:采用回顾性调查方法,分析190例晚期肺癌患者肺部感染、痰菌培养及药敏试验的临床资料。结果:培养出病原菌252株,其中真菌49株,细菌203株;细菌中革兰氏阴性菌占65.5%,革兰氏阳性菌占34.5%。革兰氏阴性菌主要为大肠杆菌、非发酵菌属、铜绿假单胞菌、肺炎克雷伯菌;革兰氏阳性菌主要为粪肠球菌、表皮葡萄球菌、溶血葡萄球菌。革兰氏阴性菌主要对氨基糖甙类、喹诺酮类、碳青霉烯类敏感;革兰氏阳性菌主要对万古霉素敏感。抗真菌治疗主要用氟康唑或伏立康唑。结论:肺癌患者肺部感染多为革兰氏阴性菌感染,混合性感染以及二重感染比例较高;各种致病菌对常用抗生素存在着不同程度耐药性,临床医生应根据药敏试验结果合理使用抗生素。

Objective：To observe the characteristics of pathogen and antifungal susceptibility experiment in the advanced lung cancer patients with pulmonary infection. Methods：The clinical data of pulmonary infection in 190 patients with terminal lung cancer, pathogens and antifungal susceptibility experiment was analyzed in a retrospective way. Results： Two hundred and fifty-two pathogens were cultivated, induding 49 fungal and 203 bacteria, of which 65.5% was Gram-negative bacteria. The other was Gram-positive bacteria. The main Gram-hegative bacteria were sensitive to aminoglycosides ; quinolones, the main Gram positive bacteria were sensitive to vancomycin. Use Fluconazole or vorionazole to treat fungal. Conclusion： Due to the low level of immunity, the patients with advanced lung cancer were susceptible to the pulmonary infection, which was caused by several pathogens. All of the conditioned pathogen had different extent to the commonly used antibiotics and the tolerance, so it suggests that antibiotics were used properly according to antifurgal susce ptibility experiment in clinic.