鼻咽癌患者同步放化疗期间口咽部感染病原菌及其影响因素

Pathogens and influencing factors for oropharyngeal infection in patients with nasopharyngeal carcinoma during concurrent radiotherapy and chemotherapy

目的研究鼻咽癌患者同步放化疗期间口咽部感染病原菌与影响因素及防治策略。方法回顾性分析2018年5月-2019年6月杭州市肿瘤医院鼻咽癌同步放化疗患者80例的资料,加强放化疗期间口咽部感染患者监测、检测病原菌类型;分析患者性别、年龄、基础疾病等临床资料,归纳鼻咽癌患者同步放化疗期间口咽部感染的影响因素,根据影响因素制定相应防治策略。结果口咽部感染26例,感染率为32.50%;共培养分离病原菌33株,其中真菌20株占60.61%,革兰阴性菌10株占30.30%,革兰阳性菌3株占9.09%。口腔环境、口腔黏膜炎症反应程度是鼻咽癌患者同步放化疗期间口咽部感染的影响因素(P<0.05)。结论本地区鼻咽癌患者同步放化疗期间口咽部感染病原菌以真菌为主,应对口腔环境、口腔黏膜炎症的患者加强监测,为临床下一步防控提供参考依据。

OBJECTIVE To study the pathogens and influencing factors of oropharyngeal infection in patients with nasopharyngeal carcinoma(NPC)during the period of radiotherapy and chemotherapy,as well as prevention and treatment strategies.METHODS The data of 80patients with nasopharyngeal carcinoma underwent radiotherapy and chemotherapy treatment in Hangzhou cancer hospital from May 2018to Jun.2019were retrospectively analyzed.The monitoring and detection of pathogenic bacteria were strengthened during radiotherapy and chemotherapy.The clinical data of patients,such as sex,age and basic diseases were analyzed.The influencing factors of oropharyngeal infection in patients with nasopharyngeal carcinoma during radiotherapy and chemotherapy were summarized,and the corresponding prevention and control strategies were formulated according to the influencing factors.RESULTS Twenty-six cases of oropharyngeal infection were detected,and the infection rate was 32.50%.A total of 33strains of pathogenic bacteria were isolated,of which 20strains of fungi accounted for 60.61%,10 strains of Gram-negative bacteria accounted for 30.30%,and 3strains of Gram-positive bacteria accounted for 9.09%.The oral environment and the degree of oral mucosa inflammation were the influencing factors of oropharyngeal infection in patients with nasopharyngeal carcinoma during concurrent radiotherapy and chemotherapy(P<0.05).CONCLUSIONDuring the period of concurrent radiotherapy and chemotherapy for oropharyngeal cancer patients in this region,the pathogens of oropharyngeal infection were mainly fungi.The monitoring on the oral environment and oral mucosa inflammation of patients should be strengthened to provide a reference for further clinical prevention and control.