肺癌患者合并肺部真菌感染的临床分析

Clinical Analysis of Nosocomial Pulmonary Fungal Infection in Patients with Lung Cancer

目的分析肺癌患者并发肺部真菌感染的影响因素及临床特点,以有效预防和控制感染。方法收集新疆肿瘤医院2007年1月～12月出院的872例肺癌患者的临床资料,对其中合并肺部真菌感染的87例资料总结,分析真菌感染的影响因素及真菌种类特点。结果872例肺癌患者中,肺部真菌感染87例,感染发生率9.9%。真菌类型主要为念珠菌菌属(96.6%),其中白色念珠菌(81%)为主要菌种,主要影响因素有年龄≥50岁,Ⅲ～Ⅳ期的中晚期肺癌患者、住院时间≥14天、化疗、放疗,侵袭性操作、白细胞减少≥Ⅲ度,长时间使用抗生素及激素(P<0.05)。而患者的性别,肺癌的病理分型,是否行手术治疗与肺部真菌感染无关(P>0.05)。结论减少易感因素,及时治疗是降低肺癌患者真菌感染的有效措施。

Objective To analyze the clinical features and influence factors on the nosocomial pulmonary fungal infection in patients with lung cancer for the effective prevent and control of nosocomial infection.Methods Eight hundred and Seventytwo cases of patients with lung cancer from Jan. 2007 to Dec.2007.in Xinjiang Tumor Hospital were retrospectively analyzed. Among of them, 87 patients with nosocomial pulmonary fungal infection were analyzed to get the risk factors and fungal zategorization. Results The pulmonary fungal infection rate in the 872 patients with lung cancer was 9.9%. The candida accounted for 96.6%of the fungal,and 81% of the candida was candida albicans. The main risk factors included age （≥50 years old）, long-term hospitalization （≥14d）, cancer chemotherapy and radiaotherapy, invasive operation, leucopenia （≥Ⅲ grade）, and long-term application of antibiotic and homone （P〈0.05）. Gender, lung cancer pathotype and operation had nothing to do with the nosocomial pulmonary fungal infection in patients with lung cancer （P〉0.05）. Conclusion The effective method to reduce nosocomial pulmonary fungal infection in patient with cancer is to avoid the risk factors, to diagnose early, and to use anti-fungus agents early.