摘要
目的研究分析膀胱肿瘤患者灌注化疗后并发尿路感染的影响因素及相关预防干预措施。方法选择医院2015年4月-2017年4月收治的膀胱肿瘤接受灌注化疗的患者1 613例作为研究对象,观察膀胱肿瘤患者灌注化疗后并发尿路感染情况,并分析其相关因素,提出对应性预防干预措施。结果 1 613例膀胱肿瘤患者灌注化疗后并发尿路感染共382例,占23.68%。尿液培养共发现病原菌424株,以革兰阴性菌为主,占69.10%,其中以大肠埃希菌和鲍氏不动杆菌为主,分别占25.47%、19.10%,二者对左氧氟沙星及美罗培南具有较强的药物敏感性,对头孢噻肟、头孢西丁、头孢吡肟具有较强的耐药性。年龄≥65岁、白蛋白水平<35 g/L、灌注化疗次数≥5次、留置导尿管、多个肿瘤位点、合并糖尿病均是膀胱肿瘤患者灌注化疗后并发尿路感染的独立影响因素(P<0.05)。结论膀胱肿瘤患者灌注化疗后并发尿路感染比例较高,且受多种因素影响。临床上治疗膀胱肿瘤并行灌注化疗的患者的同时,需提高预防感染的认识程度,针对存在的影响因素,给予相应预防干预措施,降低尿路感染发生率。
OBJECTIVE To expore the influenicng factors for complicated urinary tract infection in bladder tumor patients after perfusion chemotherapy and put forward targeted prevention interventions. METHODS A total of 1 613 bladder tumor patients who received perfusion chemotherapy in the hospital from Apr 2015 to Apr 2017 were recruited as the study objects, the incidence of complicated urinary tract infection was investigated after the perfusion chemotherapy, the related factors for the infection were analyzed, and the targeted prevention interventions were put forward. RESULTS Of the 1 613 bladder tumor patients, 382(23.68%) had urinary tract infection after the perfusion chemotherapy. Totally 424 strains of pathogens were isolated from urine specimens, 69.10% of which were gram-negative bacteria;Escherichia coli and Acinetobacter baumannii were the predominant species of the gram-negative bacteria, accounting for 25.47% and 19.10%, respectively, and the two species were highly susceptible to levofloxacin and meropenem but were hihgly resistant to cefotaxime, cefoxitin and cefepime. The no less than 65 years of age, albumin level less than 35 g/L, no less than 5 times of perfusion chemotherapy, urinary catheter indwelling, multiple tumor sites and complication with diabetes mellitus were the independent influencing factors for the complicated urinary tract infection in the bladder tumor patients after the perfusion chemotherapy(P<0.05). CONCLUSION The incidence of complicated urinary tract infection is high among the bladder tumor patients after the perfusion chemotherapy and is affected by a variety of factors. It is necessary for the hospital to pay great attention to the prevention of urinary tract infection in the bladder tumor patients undergoing perfusion chemotherapy and take targeted prevention interventions according to the influencing factors so as to reduce the incidence of urinary tract infection.
作者
简毓
吴曦
张鹏
陈安建
黄翔
罗旭
JIAN Yu;WU Xi;ZHANG Peng;CHEN An-jian;HUANG Xiang;LUO Xu(Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第14期2138-2142,共5页
Chinese Journal of Nosocomiology
基金
贵州省自然科学基金资助项目(黔科合LH字[2014]7551号)
关键词
膀胱肿瘤
灌注化疗
尿路感染
影响因素
预防干预措施
Bladder tumor
Perfusion chemotherapy
Urinary tract infection
Influencing factor
Prevention intervention
