恶性肿瘤患者医院感染分析与对策

Analysis of hospital infections occurred in patients with malignant tumors and the nursing countermeasures

目的 探讨恶性肿瘤患者医院感染的相关因素,采取有效的护理对策,降低肿瘤科医院感染发生率.方法 回顾性调查分析2006年～2008年笔者所在医院肿瘤科患者发生医院感染的资料.结果 1 958例住院性肿瘤患者,132例发生医院感染,按感染年限分：2006年感染率7.87%（42/534）、2007年感染率6.86%（43/627）、2008年感染率5.90%（47/797）;按感染部位分：呼吸道感染居首位,占53.03%,其他依次为消化道感染（21.21%）、血管相关性感染（10.61%）、尿路感染（6.06%）、皮肤软组织感染（5.30%）、其他部位（3.79%）.医院感染的非血液性肿瘤基础病以肺癌为主,依次为鼻咽癌、消化道肿瘤及乳腺癌;感染的发生与使用放、化疗治疗、不合理使用抗生素、患者年龄、肿瘤期别、住院时间、侵入性操作等因素有关.结论 加强职业道德教育、切断传播途径、做好基础护理、合理使用抗生素是预防和控制医院感染的关键.

Objective To investigate the hospital infection - related factors in patients with malignant tumors, and to take effective nursing measures to reduce the incidence of hospital infection in the department of oncology. Methods The hospital infection data from 2006 to 2008 occurred in patients with malignant tumors in the department of oncology were retrospectively analyzed. Results 132 cases of hospital infections occurred among 1 958 hospitalized patients with malignant tumors from 2006 to 2008. The hospital infection rates were 7.87% （42/ 534） in 2006, 6. 86% （43/627） in 2007, and 5.90% （47/797） in 2008, respectively. According to the site of infection points： respiratory infections ranked first, accounting for 53.03%, followed by digestive tract infection （21.21%）, vascular - related infections （ 10. 61% ）, urinary tract infection（6. 06% ）, skin and soft tissue infections （5.30%）, and the other sites （3.79%）. Among the non - blood - based diseases, the hospital infections mainly occurred in lung cancers, followed by nasopharyngeal cancer, gastrointestinal cancer, and breast cancer. The incidence of infections were related with the use of radiotherapy and chemotherapy treatment, irrational use of antibiotics, patient age, tumor phases, hospitalization time, invasive procedures and other factors. Conclusions Strengthening of professional ethics education, cut off the transmission, good job - based nursing, rational use of antibiotics are the keys to preventing and controlling of hospital infections.