肿瘤患者医院感染原因分析及预防对策

Causes of infections in 168tumor patients and prevention countermeasures

目的探讨恶性肿瘤患者医院感染的原因并提出相应的预防措施,以期能为预防及控制恶性肿瘤患者并发医院感染提供参考。方法对医院2008年1月-2012年8月收治的517例恶性肿瘤患者临床资料进行回顾性分析,分析恶性肿瘤患者并发医院感染的危险因素。结果 517例恶性肿瘤患者并发医院感染168例,感染率32.50%;感染部位中呼吸道感染82例占48.81%,消化道感染12例占7.14%,泌尿道感染28例占16.67%;单因素分析结果显示,性别、年龄、放化疗、并发症、使用免疫抑制剂、白细胞低于正常、住院时间、侵入性操作均是引起患者并发医院感染发生的单危险因素(P<0.05);多因素logistic回归分析显示,高龄、放化疗、并发症、白细胞低于正常、使用免疫抑制剂、住院时间长、侵入性操作均是导致患者发生医院感染的独立危险因素(P<0.05)。结论恶性肿瘤患者易合并医院感染,感染时多因素综合作用影响所致,控制相关危险因素是预防治疗恶性肿瘤患者并发医院感染的主要措施。

OBJECTIVE To explore the causes of nosocomial infections in patients with malignant tumors and put forward corresponding prevention countermeasures so as to provide basis for the prevention and control of nosoco- mial infections in the patients with malignant tumors. METHODS The clinical data of 517 malignant tumor patients who were treated in the hospital from Jan 2008 to Aug 2012 were retrospectively analyzed, then the risk factors of nosocomial infections in the malignant tumor patients were analyzed. RESULTS Of totally 517 cases of malignant tumor patients investigated, the nosocomial infections occurred in 168 cases with the infection rate of 32.50%, among which there were 82 （48.81%） cases with respiratory tract infections, 12 （7.14%） cases with gastrointes- tinal tract infections, and 28 （16.67%） cases with urinary tract infections. The univariate analysis indicated that the gender, age, radiation and chemotherapy, complications, use of immune inhibitors, leukocyte below normal, length of hospital stay, and invasive operation were the risk factors of nosocomial infections （P〈0.05） ; while the multivariate logistic regression analysis showed that the advanced age, radiation and chemotherapy, complica- tions, leukocyte below normal, use of immune inhibitors, long length of hospital stay, and invasive operation were the independent risk factors of nosocomial infections in the patients （P〈0. 05）. CONCLUSION The nosocomial infections in the malignant tumor patients are caused by many factors; to control the related risk factors is an effective way to prevent and treat the nosocomial infections in the malignant tumor patients.