摘要
目的了解恶性肿瘤患者手术后发生医院获得性真菌性肺炎(HAFP),分析其危险因素,并探讨护理对策。方法采用回顾性调查方法,对2009年1月-2011年12月接受手术的558例肺癌、食管癌、纵隔肿瘤、胃癌和鼻咽癌患者临床资料进行统计分析,要求HAFP确诊患者应具有肺部感染症状,从痰液或气道刷检液标本中至少2次分离到相同的真菌。结果 3年共发生HAFP患者66例,总感染率为11.8%;感染率以肺癌和食管癌最高,分别为24.2%和16.0%,其次是鼻咽癌、纵隔肿瘤和胃癌,分别为14.3%、11.8%和2.2%;患者年龄、住院时间、机械通气、抗肿瘤药物、激素/免疫抑制剂和抗菌药物的长时间使用是发生HAFP的主要危险因素;HAFP的病原菌主要是假丝酵母菌属,共63株占95.5%。结论加强对肿瘤患者的心理疏导,加强对其他疾病的治疗,控制侵入性医疗操作,合理使用激素及和抗菌药物,严格各项无菌医疗操作是降低HAFP感染率的有效措施。
OBJECTIVE To study the risk factors and nursing strategies for the hospital-acquired fungal pneumonia（HAFP）in the patients with malignant tumor patients after surgery so as to put forward the nursing countermeasures.METHODS By means of the retrospective survey,the medical records of 558 cases of patients with lung cancer,esophageal cancer,gastric cancer,mediastinal tumor or nasopharyngeal carcinoma who had received the surgery between Jan.2009 and Dec.2011 were statistically analyzed,the HAFP was identified withlung infection symptoms,and the same species of fungi were isolated at least twice from sputum or airway flushing fluid.RESULTS The HAFP occurred in 66cases in 3 years with the total infection rate of 11.8%.The infection rate was highest in the patients with lung cancer（24.2%）or the patients with esophageal cancer（16.0%）,followed by the patients with the nasopharyngeal carcinoma（14.3%）,the patients with mediastinal tumor（11.8%）,and the patients with gastric cancer（2.2%）.The age,hospital stay,mechanical ventilation,and long term use of antineoplastic,hormone and immunosuppressor,or antibiotics were the risk factors of the HAFP.The Candida were the predominant pathogens causing HAFP,there were totally 63（95.5%）strains.CONCLUSIONIt is an effective way to reduce the infection rate to conduct more psychological counseling for the tumor patients,remedy the diseases accompanied,reduce the invasive operation,use hormone and antibiotics rationally and pay more attention to the aseptic operation.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第14期3382-3384,共3页
Chinese Journal of Nosocomiology
