高龄恶性肿瘤患者医院感染的临床分析及对策

Clinical analysis of nosocomial infections in senile malignant carcinoma patients and countermeasures

目的探讨高龄恶性肿瘤患者医院感染的致病因素及防治对策。方法对医院近3年来入院治疗的高龄恶性肿瘤患者,发生医院感染的感染部位、致病因素和病原菌分布等进行分析,并对如何控制医院感染总结经验、提出对策。结果 518例入院治疗的高龄恶性肿瘤患者中,发生医院感染108例,发生感染最多的是胰腺癌、食道癌,>40.0%;感染部位以呼吸道为首位占69.4%,其次为呼吸道与泌尿道的合并感染占21.3%;革兰阴性菌为主要病原菌占56.7%,其次为真菌占30.9%,革兰阳性菌占10.1%。结论老年恶性肿瘤患者医院感染概率较高,其主要诱因包括肿瘤、放疗、化疗、手术、高龄、并发症等导致的免疫力低下、菌群失调、长期住院等;应从多方面采取综合防治措施控制医院感染的发生率。

OBJECTIVE To investigate the pathogenesis and control of nosocomial infection occurred in senile malignant carcinoma patients. METHODS The clinical materials of aged malignant carcinoma patients were collected and undergone nosocomial infection analysis for distribution, pathogen, and so on. Experiences in administration and control of nosocomial infection from our hospital were discussed. RESULTS Totally, materials of 518 events were collected from hospitalized patients. Among them, 108 events were determined occurring nosocomial infection. Patients carrying pancreatic and esophageal carcinoma displayed highest infection rate （〉40M）. Infection location mainly distributed in respiratory tract （69.4%）, also in combination of respiratory and urinary tract （21.3%）. Pathogen analysis showed that Gram-negative bacterials （56. 7%） were dominant species, followed by fungi （30.9%） and Gram-positive bacteria （10. 1%）. CONCLUSION Senile malignant carcinoma patients were vulnerable to get nosocomial infection for complex reasons including malignancy, radiation-and chemo-therapy, surgery, age, complication symptoms, and so on. Strict administrations must be taken to reduce the incidence rate of nosocomial infection.