老年肿瘤放化疗患者医院感染相关因素分析

Related factors for nosocomial infections in senile patients undergoing chemoradiotherapy

目的分析老年肿瘤放化疗患者医院感染相关因素,并探讨预防对策,以改善患者预后及生存质量。方法对医院肿瘤科2007年6月-2010年5月577例行放化疗的老年肿瘤患者进行回顾性分析,按照是否发生医院感染分为感染组98例及非感染组479例,对比两组患者一般资料,并对存在统计学差异的指标进行多因素回顾性分析,探讨感染因素及预防对策。结果 577例患者中共出现98例医院感染,感染率16.98%;多因素回归分析发现,营养状态差、侵入性操作、白细胞下降及应用抗菌药物是影响老年肿瘤放化疗患者医院感染的独立危险因素(P<0.05)。结论针对老年肿瘤放化疗患者医院感染的独立危险因素,应采取营养支持、严格无菌操作、合理应用抗菌药物并定期行口腔及胃肠道护理,以改善患者免疫功能,降低患者感染率。

OBJECTIVE To explore the related factors for nosocomial infections in the senile patients undergoing chemoradiotherapy and put forward the prevention countermeasures so as to improve the prognosis and the quality of life. METHODS A total of 577 cases of senile patients who underwent the chemoradiotherapy in the hospital from Jun 2007 to May 2010 were retrospectively analyzed and divided into the infection group with 98 cases and the non-infection group with 479 cases according to the status of nosocomial infections, then the general data were compared between the two groups, the multivariate analysis was performed for the indicators that had significance the risk factors for the infections were observed so as to put forward the prevention countermeasures. RESULTS Of totally 577 cases of patients investigated, the nosocomial infections occurred in 98 cases with the infection rate of 16.98%. The multivariate regression analysis showed that the poor nutrition status, invasive operation, declined leucocytes and use of antibiotics were the independent risk factors for nosocomial infections in the senile patients undergoing the claemoradiotherapy （P〉0.05）. CONCLUSION In response to the independent risk factors for the nosocomial infections in the senile patients undergoing the chemoradiotherapy,it is necessary to take the nutrition support, carry out the aseptic operation, reasonably use antibiotics, and perform the oral and gastrointestinal tract care regularly so as to improve the immunity of the patients and reduce the infection rate.