肺癌患者放化疗后肺部感染的相关因素分析

Related factors for pulmonary infections in lung cancer patients after chemoradiotherapy

目的探讨肺癌患者放化疗后并发肺部感染的相关因素,为预防肺癌患者放化疗后肺部感染提供参考依据。方法回顾性分析2009年1月-2013年1月240例行放化疗治疗的肺癌患者临床资料,观察患者放化疗后肺部感染及对感染的相关因素进行单因素和多因素logistic回归分析。结果 240例患者发生肺部感染46例,感染率为19.17%,且经血培养发现,感染患者均为复合感染;单因素分析结果显示,患者年龄、长期大量吸烟史、联合≥2种药物化疗、≥3种基础疾病、化疗时间、化疗后白蛋白<30g/L、化疗前体力状况评分(KPS)和复合感染等与肺癌患者放化疗后并发肺部感染相关(P<0.05);多因素logistic回归分析显示,患者年龄、联合≥2种化疗药物、化疗时间、化疗后白蛋白<30g/L、化疗前体力状况评分(KPS)和复合感染是肺癌放化疗后发生肺部感染的独立危险因素。结论肺癌患者在放化疗期间容易发生肺部感染,且影响因素较多,需要引起临床医师的关注。

OBJECTIVE To explore the related factors for concurrent pulmonary infections in the lung cancer pa-tients after chemoradiotherapy so as to provide guidance for prevention of pulmonary infections in the lung cancer patients after the chemoradiotherapy .METHODS The clinical data of 240 lung cancer patients who underwent the chemoradiotherapy from Jan 2009 to Jan 2013 were retrospectively analyzed ,then the univariate analysis and mult-ivariate logistic regression analysis were performed for the related factors for pulmonary infections .RESULTS The pulmonary infections occurred in 46 of 240 patients ,with the infection rate of 19 .17% ;the blood culture showed that all the patients were with complex infections .The result of univariate analysis indicated that the age ,long-term and heavy smoking history ,combination use of no less than two drugs for chemotherapy ,no less than three underlying diseases ,chemotherapy time ,albumin level less than 30 g/L after chemotherapy ,physical strength score before chemotherapy ,and complex infections were associated with the concurrent pulmonary infections in the lung cancer patients after the chemoradiotherapy （P〈0 .05） .The multivariate logistic regression analysis showed that the age ,combination use of no less than two drugs for chemotherapy ,chemotherapy time ,albumin level less than 30g/L after chemotherapy ,physical strength score before chemotherapy ,and complex infections were the in-dependent risk factors for the pulmonary infections in the lung cancer patients after the chemoradiotherapy . CONCLUSION The lung cancer patients are vulnerable to pulmonary infections during the chemoradiotherapy ,and there are a variety of influencing factors ,which the clinicians should pay high attention to .