摘要
目的研究食管癌术后化疗患者发生肺部感染的危险因素及菌群分布特点。方法选取2015年1月-2017年1月在医院接受根治性手术后行化疗的79例食管癌患者。按照患者术后化疗是否存在肺部感染分为感染组和未感染组,比较两组患者年龄、性别、糖尿病史、高血压史、冠状动脉粥样硬化性心脏病(CAHD)、慢性阻塞性肺疾病(COPD)、吸烟史、手术时间、术前肺功能、术中出血量、病理分期等临床资料。结果 79例食管癌术后化疗患者,27例发生肺部感染患者,感染率31.18%。肺部感染组中年龄>60岁、糖尿病史、伴有COPD、吸烟史、手术时间>4h的患者多于未感染组(P<0.05)。多因素logistic回归分析显示,年龄>60岁、糖尿病史、伴有COPD、吸烟史、手术时间>4h是食管癌术后化疗患者肺部发生感染的独立危险因素(P<0.05)。27例肺部感染患者,共培养病原菌36株。以革兰阴性菌为主。结论高龄、糖尿病、COPD、吸烟史、较长的手术时间是影响食管癌术后化疗患者肺部发生感染的独立危险因素,肺部感染病原菌以革兰阴性菌为主。
OBJECTIVE To explore the risk factors for the pulmonary infection in the radical esophagectomy patients undergoing postoperative chemotherapy and analyze the distribution of pathogens.METHODS From Jan 2015 to Jan 2017,a total of 79 patients with esophageal cancer who received the chemotherapy after the radical esophagectomy were enrolled in the study and divided into the infection group and the non-infection group according to pulmonary infection whether occurring after the chemotherapy.The clinical data,including the age,gender,history of diabetes mellitus,history of hypertension,coronary atherosclerotic heart disease(CAHD),chronic obstructive pulmonary disease(COPD),smoking history,operation duration,preoperative lung function,intraoperative blood loss volume and pathological stage,were observed and compared between the two groups of patients.RESULTS Of the 79 esophageal cancer patients who receive the postoperative chemotherapy,27 had pulmonary infection,with the incidence rate 31.18%.The number of the patients with the more than 60 years of age,history of diabetes mellitus,complication of COPD,smoking history and operation duration mreo than 4 hours was significantly larger in the infection group than in the non-infection group(P<0.05).Multivariate logistic regression analysis indicated that the more than 60 years of age,history of diabetes mellitus,complication of COPD,smoking history and operation duration more than 4 hours were the independent risk factors for the pulmonary infection in the esophageal cancer patients undergoing postoperative chemotherapy(P<0.05).Totally 36 strains of pathogens were isolated from the 27 patients with pulmonary infection,among which gram-negative bacteria were dominant.CONCLUSIONThe advanced age,diabetes mellitus,COPD,smoking history and long operation duration are the independent risk factors for the pulmonary infection in the esophageal cancer patients undergoing postoperative chemotherapy.The gram-negative bacteria are dominant among the pathogens causing the pulmonary infection.
作者
王琼育
李标
李凡
李富
符敦志
WANG Qiong-yu;LI Biao;LI Fan;LI Fu;FU Dun-zhi(The Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570311,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期81-83,共3页
Chinese Journal of Nosocomiology
基金
海南省科学基金资助项目(81060276)
关键词
食管癌
肺部感染
影响因素
菌群
Esophageal cancer
Pulmonary infection
Risk factor
Flora
