肿瘤化疗感染的危险因素分析及应对措施

Risk factors for nosocomial infections during cancer chemotherapy and response measures

目的分析肿瘤化疗感染的危险因素,制定相关应对措施,以减少肿瘤化疗患者感染发生。方法回顾性分析医院收治的1122例肿瘤化疗患者临床资料,对肿瘤化疗后医院感染的危险因素进行分析,在此基础上针对危险因素采取应对措施。结果共有169例肿瘤化疗患者发生感染,感染率为15.1%;多因素logistic回归分析结果显示:年龄(β=1.417,OR=2.027)、住院天数(β=1.562,OR=3.997)、侵入性操作(β=1.544,OR=2.455)、合并糖尿病(β=1.718,OR=4.397)、伴皮肤或黏膜型溃疡(β=1.699,OR=2.701)是肿瘤化疗感染的独立危险因素(P<0.05)。结论医院肿瘤化疗感染患者的危险因素多数是非人为因素,甚至是不可避免的治疗行为导致的,针对可人为改善的因素加强管理,使患者的生命健康得到最大化的保证,针对危险因素做好预防措施,以减少感染的发生。

OBJECTIVE To analyze the risk factors for nosocomial infections during the cancer chemotherapy and to develop the corresponding countermeasures so as to reduce the incidence of infections in the cancer patients undergoing chemotherapy. METHODS The clinical data of 1122 cancer patients who underwent the chemotherapy in the hospital were retrospectively analyzed, the risk factors of nosocomial infections that occurred after the chemotherapy were analyzed, the countermeasures were taken in response to the risk factors. RESULTS The infections occureel in 169 cuses of tumor patients with the infection rate of 15. 1%. The multivariate logistic regression analysis showed that the age（β= 1. 417 ,OR= 2. 027）, hospital stay（β= 1. 562, OR= 3. 997）, invasive operation（β= 1. 544,OR=2. 455）, diabetes mellitus（β= 1. 718,0R=4. 397）, and complication of skin or mucous membrane type ulcers （β=1. 699, OR = 2. 701）were the independent risk factors for the nosocomial infections in the patients undergoing cancer chemotherapy（P〈0.05）. CONCLUSION Most of the risk factors for the infections are non-human factors, even the inevitable factors due to the treatment. The prevention measures should be taken in response to the risk factors so as to reduce the incidence of infections. To strengthen the management in response to the factors that can be artificially improved can maximize the guarantee of the patients＇health.