胸科术后肺部真菌感染的相关因素分析

ANALYSIS OF RELATED FACTORS TO PULMONARY FUNGAL INFECTION IN THORACIC POSTOPERATIVE PATIENTS

目的 :探讨胸外科术后肺部真菌感染的相关因素 ,为临床预防及治疗提供相应的理论依据。方法 :作者所在医院 1990～ 2 0 0 0年间共收治普胸病人 2 0 90例 ,术后发生肺部真菌感染的 38例 ,通过回顾性病例对照研究 ,分折、肿瘤分期、术前放化疗及术前应用广谱抗菌素与术后肺部真菌感染的相关性。结果 :Ⅲ -Ⅳ期肿瘤、术前放化疗及术前应用广谱抗菌素的病例在病例组中的构成比显著高于对照组 ,具有统计学意义 ;而年龄、贫血、低蛋白血症的病例在两组中的构成比无显著差异。结论 :Ⅲ -Ⅳ期肿瘤、术前放化疗及术前应用广谱抗菌素与术后肺部真菌感染有明确的相关性 ,可分别作为独立的危险因素 ,术前对这类因素的评估和处理 。

Objective: In order to provide theoretical b asis for clinical prophylax is and therapy of pulmonary fungal infection in postoperative patients of thorac ic surgery, the related factors were investigated. Methods: Retrospective study w as conducted in 38 patients with postoperative pulmonary fungal infection out of 2090 hospitalized general thoracic patients from 1990～2000 in author's hospita l, the relationship between pulmonary fungal infection and tumor stage, radioche motherapy or broad spectrum antibiotic administered before operation were all in vestigated, other factors (age, ferrohemoglobin, etc) were taken into account at the same time. Result: In cage group, the constituent ratio of the patients with tumor stage Ⅲ～Ⅳ, preoperative radiochemotherapy, and preoperative treatment w i th broad spectrum antibiotic was significantly higher than that of control group , while with respect to age, ferrohemoglobin, and serum albumin, the constituent ratio of patients in the two groups was not significantly different. Conclusion: Tumor stage Ⅲ～Ⅳ, preoperative radiochemotherapy, and preoperative treatment w ith broad spectrum antibiotic were significantly correlated to postoperative fun gal infection. Preoperative evaluation and treatment of these related factors wo uld be beneficial to preventing postoperative pulmonary fungal infection.