恶性肿瘤放疗患者医院感染特征分析

Nosocomial Infection Characteristics Analysis about Malignant Tumor Patients in the Radiotherapy Department

目的分析恶性肿瘤患者放疗后医院感染的临床特点,提出预防感染的有效措施,为降低医院感染率提供理论依据。方法应用医院感染病例监测软件的性能,对2012年1月-2013年12月3757例恶性肿瘤放疗患者医院感染发生情况进行回顾性调查,并对临床医师上报的医院感染病例进行核实,以获得其发生医院感染的临床资料。结果 252例恶性肿瘤患者发生医院感染,感染率为6.7%;感染例次274,例次感染率为7.3%;感染部位以呼吸道感染为主,其中上呼吸道感染占43.1%,下呼吸道感染占27.4%;发生医院感染的病原菌以大肠埃希菌为主,占32.70%;送检标本率77%,其中无菌血液标本送检占41%;感染率居前三位的肿瘤分别为肾癌、头颈部癌及食管癌;感染病例中有白细胞数<4.0×109/L患者占88.5%;感染组病例住院时间明显高于没有感染组(P<0.05)。结论肾癌、头颈部癌及食管癌患者在进行放疗后易发生医院感染,应加强保护性隔离措施,监测并预防放疗反应的发生,合理使用抗菌药物。

Objectives To analyze the clinical characteristics and preventive measures of nosocomial infection about patients with malignant tumour in the radiotherapy department,which provides the theoretical basis to reduce nosocomial infection rates.Methods Analysing the clinical data which were 3757 nosocomial infection patients with malignant tumor after radiation and by prospective investigation from January 2012 and December 2013 by Application of hospital infection monitoring software performance.And to verify the clinicians report of nosocomial infection cases in order to obtain the clinical data of nosocomial infection.Results 252 patients had nosocomial infection and the infection rate was 6.7%.The number of infection cases was 274 and infection rate was 7.3%.The infection was given priority to with respiratory tract infection including the upper respiratory tract infection （43.1%）,lower respiratory tract infection （27.4%）.The occurrence of nosocomial infection pathogens was given priority to with e.coli,accounted for 32.70%.Samples detection rate 77%,with sterile blood specimens were accounted for 41%.The top three infection tumors are kidney cancer,head and neck cancer and esophageal cancer respectively.Patients with white blood cell count＆lt;4.0×109/L accounted for 88.5%.Hospitalized time of infection group was obviously higher than that of no infection group （P〈0.05）.Conclusion These patients with basic diseases and renal cancer,head and neck cancer and esophageal cancer were easily occurred to nosocomial infection after radiotherapy because of low immune function.So we must strengthen the protective isolation measures,complete the ward management,use antimicrobial agents rationally.