保护性隔离对乳腺癌术后化疗患者感染的预防价值

Value of protective isolation in prevention and control of infections in breast cancer patients undergoing postoperative chemotherapy

目的探讨保护性隔离对乳腺癌术后化疗患者感染的防控价值,为临床应用提供参考依据。方法选取2013年1月-2015年12月医院收治118例乳腺癌术后化疗患者为研究对象,随机分为观察组和对照组,两组各59例;对照组给予常规预防感染的护理措施,观察组在此基础上实施保护性隔离措施;统计全部感染患者的感染部位、病原菌分布及构成比,比较两组的感染、发热、口腔溃疡、败血症等发生率以及患者满意度。结果 118例患者中有17例化疗后发生感染,感染率为14.4%,呼吸道(41.2%)、口腔黏膜(17.6%)是最常见的感染部位,革兰阴性菌是最常见的病原菌(45.5%);观察组患者感染率为6.8%,显著低于对照组22.0%,发热、口腔溃疡、败血症等发生率均显著低于对照组,差异有统计学意义(P<0.05);观察组患者满意度评价结果、总满意率显著优于对照组,差异有统计学意义(P<0.05)。结论对乳腺癌术后化疗患者而言,保护性隔离措施显著降低了感染的发生风险,提高了患者满意度,值得临床推广应用。

OBJECTIVE To explore the value of protective isolation in prevention and control of infections in breast cancer patients undergoing postoperative chemotherapy so as to provide guidance for clinical application. METHODS A total of 118 breast cancer patients who underwent postoperative chemotherapy in hospitals from Jan 2013 to Dec 2015 were recruited as the study objects and randomly divided into the observation group and the control group, with 59 cases in each group. The control group was given conventional nursing measures for preven- tion of infections, while the observation group was treated with the protective isolation measures on the basis of the treatment of the control group. The infection sites and constituent ratios of pathogens were statistically analyzed. The incidence of infections, fever, oral ulcer, and sepsis and the patients satisfaction were observed and compared between the two groups of patients. RESULTS The infections occurred in 17 of 118 patients after the chemotherapy, with the infection rate 14.4%. The respiratory tract and oral mueosa were the most common infec- tion sites, accounting for 41.2% and 17.6%, respectively. The gram-negative bacteria were dominant among the pathogens, accounting for 45.5%. The infection rate of the observation group was 6.8 %, significantly lower than 22.0% of the control group the incidence of fever, oral ulcer, and sepsis was significantly lower in the observation group than in the control group （P〈0.05）. The patients＇ satisfaction and total satisfaction rate were signifi- cantly better in the observation group than in the control group （P〈0.05）. CONCLUSION As for the breast cancer patients undergoing postoperative chemotherapy, the protective isolation measures significantly reduce the risk of infection and raise the patients＇ satisfaction, and it is worthy to he promoted in the hospital.