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目的探讨老年肺癌放疗患者医院感染危害因素及防治策略,以降低老年肺癌放疗患者医院感染率。方法选择2013年6月-2015年6月在医院接受放疗的468例老年肺癌患者,采集感染患者标本进行细菌培养、鉴定及药敏实验,并对老年放疗患者医院感染的相关因素进行分析。结果 468例患者发生感染96例,感染率为20.51%,感染部位以上呼吸道感染为主,感染率为36.46%,其次为下呼吸道感染,感染率为27.08%;从96例感染患者送检标本中共分离出202株病原菌,其中革兰阳性菌占34.16%;革兰阴性菌占58.91%;真菌占6.93%;经logistic回归分析,年龄≥70岁、合并糖尿病、长期大量吸烟史、住院时间≥25d、TNM分期Ⅳ期、白细胞<4.0×109L、放疗剂量>30Gy、合并肺部疾病、长期抗菌药物使用、侵入性操作、营养状态较差为老年肺癌放疗患者院内感染的独立因素。结论老年肺癌放疗患者医院感染危害因素较多,应根据相关危害因素积极采取对应的防治措施,以降低老年肺癌放疗患者医院感染的发生率。
Objective To investigate the risk factors of nosocomial infection and its prevention and treatment strategies in elderly patients with lung cancer and to reduce the nosocomial infection rate in elderly patients with lung cancer. Methods From June 2013 to June 2015, 468 elderly patients with lung cancer who underwent radiotherapy in our hospital were selected for bacterial culture, identification and drug sensitivity test, and the related factors of nosocomial infection in elderly patients were analyzed. Results 468 cases were infected with 96 cases, the infection rate was 20.51%. The main infection was respiratory tract infection, the infection rate was 36.46%, followed by lower respiratory tract infection, the infection rate was 27.08%. The samples were collected from 96 infected patients 202 pathogens were isolated, of which Gram-positive bacteria accounted for 34.16%; Gram-negative bacteria accounted for 58.91%; fungi accounted for 6.93%; by logistic regression analysis, age ≥70 years, with diabetes, long-term heavy smoking history, hospital stay ≥25d , TNM stage Ⅳ, white blood cells <4.0 × 109L, radiation dose> 30Gy, pulmonary disease, long-term use of antibiotics, invasive procedures, poor nutritional status of elderly patients with lung cancer radiotherapy in patients with independent factors. Conclusion Elderly patients with lung cancer radiotherapy have more nosocomial infection hazards. Corresponding prevention and treatment measures should be taken according to the relevant risk factors so as to reduce the incidence of nosocomial infections in elderly patients with lung cancer.