晚期肝癌患者TACE术后医院感染病原菌与影响因素分析

Analysis of pathogens and influence factors of nosocomial infection in patients with advanced liver cancer after TACE

目的探究中晚期肝癌患者肝动脉化疗栓塞(TACE)术后医院感染病原菌与影响因素。方法回顾性分析2014年2月-2016年2月医院TACE术后中晚期肝癌患者762例的临床资料,探讨患者发生医院感染的基本情况、病原菌情况,分析患者性别、年龄、住院时间、肿瘤分型等临床资料,归纳晚期肝癌患者TACE术后医院感染的影响因素。结果晚期肝癌患者TACE术后医院感染率为8.53%(65/762);以腹腔感染和胆道感染为主;共培养分离病原菌78株,其中革兰阴性菌49株占62.82%,以大肠埃希菌和肺炎克雷伯菌为主;革兰阳性菌25株占32.05%,以金黄色葡萄球菌为主;真菌4株占5.13%。年龄,住院时间,腹水和血清白蛋白是晚期肝癌患者TACE术后医院感染的影响因素(P<0.05)。结论 TACE术后中晚期肝癌患者医院感染率较高,主要以腹腔感染和胆道感染为主,应针对感染影响因素采取相应措施,以降低感染率。

OBJECTIVE To investigate the pathogens and influence factors of nosocomial infection in patients with advanced liver cancer after hepatic arterial chemoembolization(TACE).METHODS The clinical data of 762 patients with advanced hepatocellular carcinoma after TACE in Feb.2014-Feb.2016 were analyzed.The basic situation,pathogen characteristics and risk factors of nosocomial infection were discussed.The clinical data of the patients such as gender,age,hospitalization time and tumor typing,and the risk factors of nosocomial infection in patients with advanced liver cancer after TACE.RESULTS The nosocomial infection rate of patients with advanced liver cancer after TACE was 8.53%(65/762),and the infections were mainly abdominal infection and biliary infection.78 strains of pathogens were isolated and cultured,among which 49 strains of gram-negative bacteria accounted for 62.82%,25 strains of gram-positive bacteria account for 35.90%,and 4 strains of fungi account for5.13%.Escherichia coli and Klebsiella pneumoniae were the main gram-negative bacteria,and gram-positive bacteria were dominated by Staphylococcus aureus.Age,hospital stay,ascites and serum albumin were the influencing factors of nosocomial infection after TACE in patients with advanced liver cancer(P<0.05).CONCLUSION The incidence of nosocomial infection in patients with advanced hepatocellular carcinoma after TACE is high,and the infections were mainly abdominal infection and biliary tract infection.Targeted measures should be taken according to the risk factors,so as to reduce the infection rate.