摘要
目的研究乳腺癌术后化疗感染率及其相关危险因素,为预防乳腺癌术后化疗感染提供数据。方法分析2014年1月至2016年10月,哈尔滨医科大学第三临床医学院收治的乳腺癌术后化疗患者307例,分析化疗后感染情况及病原菌特点。结果本组307例患者,发生感染46例,感染率14.98%,主要的感染部位以呼吸道、皮肤软组织、口腔黏膜及消化道为主,分别占41.31%、17.39%、13.04%及10.87%。共分离出52株病原菌,其中革兰阴性菌23株(44.23%),革兰阳性菌16株(30.77%),真菌13株(25.00%)。多因素logistic多因素回归筛选显示,OR(95%CI)值分别为:年龄2.251(1.637~5.829),白细胞计数<4×10~9/L 4.912(2.687~9.358),住院时间3.615(1.286~9.164),化疗周期>3个7.342(3.687~11.256),抗生素使用>2种3.982(1.398~6.254),QLQ-BR23评分3.216(4.621~6.243),乳腺癌改良根治术1.689(1.036~2.036),CD4^+/CD8^+比值3.167(1.679~6.948)是乳腺癌术后化疗感染的危险因素。结论乳腺癌术后化疗患者,应主要控制呼吸道、皮肤软组织、口腔黏膜及消化道感染,针对危险因素采取控制措施,降低感染率。
Objective To understand the infection rate of breast cancer patients with postoperative chemotherapy and to analyze its risk factors. Methods Data of 307 patients with breast cancer received chemotherapy after surgery in the Third Hospital of Haerbin Medical University was collected from January,2014 to October,2016 and retrospectively analyzed for infection and the pathogenic characteristics. Results The overall infection rate was 14.98%（46/307）.Almost half of the infections occurred in respiratory tract（41.31%）,followed by infections of skin and soft tissue（17.39%）,oral mucosa（13.04%）and digestive tract（10.87%）.A total of 52 strains of bacteria were isolated,44.23% were gram-negative bacteria,30.77% were gram-positive bacteria and 25.00% were fungus.The ORvalues and their 95% CIof multi-variant logistic regression analysis for age,leucocyte count of less than 4×10~9/L,length of hospital stay,Chemotherapy cycle,Two and more antibiotics use,QLQ-BR23 score,extended radical mastectomy,CD4~＋/CD8~＋ratio were as follows：2.251（1.637-5.829）,4.912（2.687-9.358）,3.615（1.286-9.164）,7.342（3.687-11.256）,3.982（1.398-6.254）,3.216（4.621-6.243）,1.689（1.036-2.036）,3.167（1.679-6.948）.All of those factors were statistically significant. Conclusions Infections of respiratory tract,skin and soft tissue,oral mucosa and digestive tract are common ones among breast cancer patients with postoperative chemotherapy.Therefore,proper control measures targeting risk factors should be taken to lower the infection rate.
出处
《中国预防医学杂志》
CAS
CSCD
2017年第6期462-464,共3页
Chinese Preventive Medicine
关键词
乳腺癌
术后化疗
感染率
危险因素
Breast cancer
Postoperative chemotherapy
Infection rate
Risk factors
