肺癌化疗患者医院感染临床分析

目的了解肺癌化学治疗（化疗）患者并发医院感染情况及其感染部位分布与临床特点。方法对某省肿瘤医院肺癌化疗专科2003年1月-2007年12月期间收治的2 067例肺癌化疗患者临床资料进行回顾性分析。结果5年间肺癌化疗患者的医院感染发生率为7.93%，上呼吸道感染与下呼吸道感染分别占所有医院感染的51.11%和33.89%。发生与未发生医院感染的病例在平均住院天数、平均化疗周期、白细胞降低程度和粒细胞集落刺激因子使用情况等方面差异均无显著性（均P＞0.05）；Ⅲ度或Ⅳ度白细胞降低患者感染率显著升高（P＝0.000），但其中的预防性使用与未预防性使用抗菌药物者医院感染发生率差异无显著性（均P＞0.05）。结论肺癌化疗患者医院感染以上呼吸道和下呼吸道感染为主；白细胞降低较为常见，抗菌药物的预防性使用与否对Ⅲ度或Ⅳ度白细胞降低患者的医院感染率无明显影响。

Nosocomial infection in patients with lung cancer during chemotherapy: A clinical investigation

ObjectiveTo investigate the characteristics of nosocomial infection (NI) in patients with lung cancer treated by chemotherapy. MethodsA retrospective analysis on clinical data of 2 067 patients with lung cancer from January, 2003 to December ,2007 was made. ResultsThe NI rate in patients with lung cancer treated by chemotherapy was 7.93%. Upper respiratory tract infection and  lower respiratory tract infection was 51.11% and 33.89% respectively. Patients’ characteristics, including average hospital stay, average chemotherapy cycles, the degree of leukopenia and application of granulocyte colony stimulating factors were not obviously different between patients  with  and without NI (all P>0.05). NI rate increased significantly in patients with grade Ⅲ or Ⅳ leukopenia (P=0.000), but there was no difference in NI rate between patients receiving and not receiving preventive antimicrobial agents (both P>0.05).ConclusionThe most common NI in patients with lung cancer during chemotherapy are upper respiratory tract infection and   lower respiratory tract infection. Taking antimicrobial agents as a preventive measure against infection seems to have no effect on decreasing  NI rate in patients with grade Ⅲ or Ⅳ leukopenia.