肿瘤化疗患者的感染调查与危险因素分析

Nosocomial Infections in Cancer Patients during and after Chemotherapy: An Incidence Survey and Risk Factor Analysis

目的 了解肿瘤化疗患者感染的特点和危险因素。方法 回顾调查 1998～ 1999年我科收治的 42 8例肿瘤化疗患者的临床资料 ,对医院感染各项危险因素分别进行单因素分析。结果 医院感染率 2 6 .6 %,死亡率11.4%;感染部位依次是肺部、胃肠道、泌尿道 ;病原菌以革兰阴性杆菌为主 (5 5 %) ,其中克雷伯杆菌最常见 ,其次是铜绿假单胞菌等。结论 低蛋白血症、皮肤或粘膜糜烂、各种侵入性操作、长期使用广谱抗生素 (>2 0 d)、住院时间长 (>2 1d)是医院感染的危险因素 ,肺癌、白细胞下降、陪护感染是高度危险因素。

OBJECTIVE To investigate the clinical characteristics and risk factors of nosocomial infection in cancer patients during and after chemotheropy.METHODS A retrospective analysis of 114 cases suffered from nosocomial infections from 428 cases with cancer was made.RESULTS The nosocomial infection rate was 26.6% and the mortality was 11.4%. The most common site of infections was the respiratory tract, followed by gastric and urinary tract. The ratio of G - bacilli to total bacteria examined was 55%, the bacilli were mainly Klebsiella and the others were Pseudomonas aeruginosa, etc.CONCLUSIONS It was found that the risk factors of infections in cancer patients were hypoalbuminosis, skin or mucosa erosion, invasive operation, time of using broad-spectrum antibiotics (>20 days), longer hospital stay (>21 days) and the higher risk factors were lung cancer, leukocytopenia, infections due to special nursing.