晚期鼻咽癌患者同步放化疗后营养状况与医院感染的相关性分析

Correlation between nutritional status of advanced nasopharyngeal carcinoma patients after concurrent chemoradiotherapy and nosocomial infections

目的探讨晚期鼻咽癌患者同步放化疗后其营养状况及其发生医院感染的相关性进行分析。方法选择2011年2月-2015年9月医院行同步放化疗的晚期鼻咽癌患者120例,记录患者在治疗前及治疗期间体质量(W)、血红蛋白(Hb)、血清白蛋白(ALB)的变化情况,并对鼻咽癌患者治疗期间发生医院感染的相关性进行研究。结果与治疗前比较,患者在给予同步放化疗后体质量、血红蛋白及白蛋白值均明显下降(P<0.05);120例晚期鼻咽癌患者中,共94例患者发生医院感染,感染率为78.3%,115例次感染,例次感染率为95.8%;但不同性别的感染率中,男性患者明显高于女性患者(P<0.05);在给予鼻咽癌患者治疗期间共发生的115例次感染中,主要以鼻咽与口咽部黏膜的感染为主,共106例,占92.2%,115例次感染患者中共检测出病原菌74株,主要以革兰阴性菌为主共43株(58.1%),其次为真菌21株(28.4%)。结论晚期鼻咽癌患者同步放化疗后出现营养的缺失,这也进一步提高了医院感染率,临床医师应密切监测患者在治疗期间的营养状况,采取有效干预措施,控制患者治疗期间医院感染。

OBJECTIVE To explore the correlation between nutritional status of advanced nasopharyngeal carcinoma patients during concurrent chemoradiotherapy and nosocomial infections.METHODS A total of 120 patients with advanced nasopharyngeal carcinoma who received concurrent chemoradiotherapy in hospitals from Feb 2011 to Sep2015 were enrolled in the study.The body weight （W）,hemoglobin （Hb）,and serum albumin （ALB） of the patients were recorded before and after the treatment,and the association with the nosocomial infection was observed.RESULTS The W and levels of Hb and AIB were significantly reduced after the chemoradiotherapy （P〈0.05）.Of the 120 patients with advanced nasopharyngeal carcinoma,94 had nosocomial infections,with the infection rate 78.3%,and 115 case-times of patients had the infections,with the case-time infection rate 95.8%.The infection rate of the male patients was significantly higher than that of the female patients （P〈0.05）.Of the 115 case-times of patients who had the infection during the treatment,106 （92.2%） had nasopharyngeal and oropharyngeal mucosa infections.Totally 74 strains of pathogens were isolated from the 115 case times of patients with infections,of which 43 （58.1%） were gram-negative bacteria,and 12 （28.4%） were fungi.CONCLUSION The patients with advanced nasopharyngeal carcinoma may suffer from nutritional loss after the chemoradiotherapy,which leads to the increase of incidence of nosocomial infections.It is necessary for the clinicians to pay close attention to the nutritional status of the patients during the treatment and take effective intervention measures to control the nosocomial infections.