老年恶性肿瘤化疗患者医院感染及其相关因素分析

An Analysis on Risk Factors for Nosocomial Infection in Elderly Patients Undergoing Cancer Chemotherapy

[目的 ]探讨老年恶性肿瘤化疗患者医院感染发生情况及其危险因素。 [方法 ]对 2 0 0 0～ 2 0 0 2年在广东医学院附院住院化疗的 42 3例老年恶性肿瘤患者的临床资料进行分析。 [结果 ]老年恶性肿瘤化疗患者医院感染率为 17 97% ,高于医院同期医院总感染率 ;呼吸系统肿瘤与晚期肿瘤患者较易发生医院感染 ;致病菌以革兰氏阴性条件致病菌为主 ;经Logistic分析 ,医院感染主要与住院时间 (OR =2 87)、应用抗生素 (OR =2 12 )、血白细胞计数减少 (OR =2 0 0 1)、侵入性医疗操作 (OR =3 2 5 )有关。 [结论 ]缩短住院时间 ,合理应用抗生素 ,避免过多侵入性医疗操作 ,是预防老年恶性肿瘤化疗患者发生医院感染的有效措施。

Objective To investigate the prevalence and risk factors for nosocomial infection in elderly patients undergoing cancer chemotherapy.[Methods]Clinical data in 423 elderly cancer subjects undergoing chemotherapy were analyzed from 2000 to 2002 in the Affiliated Hospital of Guangdong Medical College.[Results]The incidence of nosocomial infection in elderly cancer subjects undergoing chemotherapy was 17.97%, which was superior to the overall prevalence in general patients at the same time. The patients with respiratory carcinomas and advanced tumors were prone to the acquisition of nosocomial infection. The infections were often due to gram-negative opportunistic pathogens. Logistic analysis showed that the risk factors for nosocomial infection were time of hospital stay ( OR =2.87), antibiotic treatment ( OR =2.12), reduction of peripheral blood leukocyte count ( OR =20.01), aggressive therapy ( OR =3.25).[Conclusions]It is suggested that shortening of hospital stay, antibiotic prophylaxis, avoidance of aggressive therapy are effective strategies for preventing the occurrence of nosocomial infection in elderly patients undergoing cancer chemotherapy.