老年肺癌患者术后医院感染危险因素分析

Risk factors of nosocomial infections in elderly patients with lung cancer after operation

目的调查分析老年肺癌患者术后发生医院感染的相关危险因素,为临床治疗及预防提供理论依据。方法选择2011年1月-2014年12月医院收治167例老年肺癌患者为研究对象,对其术后发生医院感染的特点及病原菌进行分析,并通过单因素和logistic多因素回顾性分析影响老年肺癌患者术后医院感染的相关危险因素。结果 167例老年肺癌患者发生医院感染51例,感染率为30.54%,其中主要以下呼吸道和口腔感染为主,分别占33.33%和15.69%;医院感染的主要病原菌为革兰阴性菌(60.78%),其次为革兰阳性菌(29.41%)和真菌(9.80%);单因素和多因素分析均显示,肿瘤晚期、侵入性操作、合并基础疾病、吸烟以及抗肿瘤治疗是术后医院感染的独立危险因素(P<0.05)。结论影响老年肺癌患者术后发生医院感染的因素主要有肿瘤晚期、侵入性操作、合并基础疾病、吸烟以及抗肿瘤治疗,临床加强对老年肺癌患者基础疾病和原发病因的控制、减少侵入性操作、及时隔离并进行相关的营养支持,以降低老年肺癌患者术后医院感染的发生。

OBJECTIVE To investigate and analyze the related risk factors of nosocomial infections in elderly patients with lung cancer after operation,so as to provide theoretical basis for clinical treatment and prevention.METHODS A total of 167 cases of elderly patients with lung cancer after operation in thoracic Department of our hospital from Jan.2011 to Dec.2014 were selected as the research subjects.The characteristics and pathogenic bacteria of nosocomial infections with postoperative patients were analyzed,and the related risk factors of nosocomial infection in elderly patients with lung cancer were retrospectively analyzed by single factor and logistic factors.RESULTS In this study,the postoperative associated nosocomial infection rate in the 167 cases of elderly lung cancer patients was 30.54%（51cases）,of which the incidence of lower respiratory tract infection and oral infection were the highest,accounting for 33.33% and 15.69%,and gram-negative bacteria were the main pathogens（60.78%）,followed by gram-positive bacteria（29.41%）and fungi（9.80%）.Both single factor and multivariate analysis showed that the independent risk factors were the late stage of tumor,invasive operation,combined basic diseases,smoking and anti-tumor therapy（P〈0.05）.CONCLUSION The independent risk factors affecting nosocomial infections in elderly patients with lung cancer after operation are mainly the late stage of tumor,invasive operation,combined basic diseases,smoking and anti tumor therapy,so the control of basic diseases and primary cause of diseases should be strengthened to reduce the invasive operation,timely isolation and related nutritional support,in order to reduce the incidence of nosocomial infections of elderly patients with lung cancer.