文章摘要
陈 玲,朱 豫,赵慧花,胡 岑,李书玲,王 军.非小细胞肺癌患者术后医院感染病原菌分布特征及慢性疼痛的影响因素探讨[J].,2021,(14):2687-2692
非小细胞肺癌患者术后医院感染病原菌分布特征及慢性疼痛的影响因素探讨
Distribution Characteristics of Pathogens Causing Nosocomial Infection in Patients with Non-small Cell Lung Cancer after Operation and Influencing Factors of Chronic Pain
投稿时间:2021-01-08  修订日期:2021-01-31
DOI:10.13241/j.cnki.pmb.2021.14.019
中文关键词: 医院感染  非小细胞肺癌  病原菌  慢性疼痛  分布特征  影响因素
英文关键词: Hospital infection  Non-small cell lung cancer  Pathogens  Chronic pain  Distribution characteristics  Influencing factors
基金项目:湖北省卫计委指导性项目(WJ2017F009)
作者单位E-mail
陈 玲 中国人民解放军中部战区总医院心胸外科 湖北 武汉 430010 xxwkchenling@163.com 
朱 豫 中国人民解放军中部战区总医院心胸外科 湖北 武汉 430010  
赵慧花 中国人民解放军中部战区总医院心胸外科 湖北 武汉 430010  
胡 岑 中国人民解放军中部战区总医院全科医学科 湖北 武汉 430010  
李书玲 中国人民解放军中部战区总医院康复科 湖北 武汉 430010  
王 军 湖北省军区武汉第三离职干部休养所门诊部 湖北 武汉430013  
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中文摘要:
      摘要 目的:观察非小细胞肺癌(NSCLC)患者术后医院感染病原菌分布特征,统计其术后慢性疼痛发生情况,分析NSCLC患者术后慢性疼痛的影响因素。方法:选取2018年3月~2020年8月期间我院收治的NSCLC患者200例,统计NSCLC患者术后慢性感染情况、发生术后慢性疼痛情况,观察NSCLC患者术后医院感染病原菌分布特征及耐药性,并分析NSCLC患者术后慢性疼痛的影响因素。结果:NSCLC患者200例,术后医院感染31例,发生率为15.50%(31/200),以呼吸道感染率最高,占比64.52%(20/31)。31 例术后医院感染患者中,共分离培养病原菌43株 ,其中革兰阳性菌13株占比30.23%(13/43),革兰阴性菌26株占比60.47%(26/43),真菌4株占比9.30%(4/43)。主要革兰阴性菌中,肺炎克雷伯菌对阿米卡星、头孢曲松耐药率较高;铜绿假单胞菌对头孢哌酮、头孢他啶耐药率较高。主要革兰阳性菌中,表皮葡萄球菌对红霉素和青霉素耐药率较高;金黄色葡萄球菌对红霉素和青霉素耐药率较高。NSCLC患者术后发生慢性疼痛25例,发生率为12.50%(25/200)。单因素分析结果显示,NSCLC患者术后慢性疼痛与年龄、住院时间、手术时长、文化程度、糖尿病史、心理焦虑有关(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、住院时间≥30d、文化程度小学及其以下、有糖尿病史、有心理焦虑为NSCLC患者术后慢性疼痛的危险因素(P<0.05)。结论:NSCLC患者术后医院感染率较高,病原菌以革兰阴性菌为主。且术后发生慢性疼痛的人数占比较高,应格外重视年龄偏大、住院时间偏长、文化程度低、有糖尿病史、心理焦虑的患者,给予相关防范措施,降低术后慢性疼痛发生率。
英文摘要:
      ABSTRACT Objective: To observe the distribution characteristics of pathogens causing nosocomial infection in patients with non-small cell lung cancer (NSCLC), the incidence of postoperative chronic pain was analyzed, to analyze the influencing factors of postoperative chronic pain in patients with NSCLC. Methods: 200 cases of NSCLC patients in our hospital from March 2018 to August 2020 were selected. The postoperative chronic infection and postoperative chronic pain of NSCLC patients were analyzed. The distribution characteristics and drug resistance of pathogens causing postoperative nosocomial infection of NSCLC patients were observed, and the influencing factors of postoperative chronic pain of NSCLC patients were analyzed. Results: Among 200 patients with NSCLC, 31 patients had postoperative nosocomial infection, the incidence rate was 15.50%(31/200), and the respiratory tract infection rate was the highest, accounting for 64.52%(20/31). In 31 cases of postoperative nosocomial infection, 43 strains of pathogenic bacteria were isolated and cultured, including 13 strains of Gram-positive bacteria, accounting for 30.23%(13/43), 26 strains of Gram-negative bacteria, accounting for 60.47%(26/43), and 4 strains of fungi, accounting for 9.30%(4/43). Among the main Gram-negative bacteria, Klebsiella pneumoniae had higher resistance rate to amikacin and ceftriaxone. Pseudomonas aeruginosa had higher resistance rate to cefoperazone and ceftazidime. Among the main Gram-positive bacteria, Staphylococcus epidermidis had higher resistance rates to erythromycin and penicillin. Staphylococcus aureus had higher resistance rates to erythromycin and penicillin. Chronic pain occurred in 25 NSCLC patients, accounting for 12.50%(25/200). Univariate analysis showed that age, length of hospital stay, duration of operation, educational level, history of diabetes and psychological anxiety were associated with chronic pain in NSCLC patients (P<0.05). Multivariate logistic regression analysis showed that age ≥60 years old, length of hospital stay ≥30 days, education level in primary school or below, history of diabetes and psychological anxiety were risk factors for postoperative chronic pain in NSCLC patients (P<0.05). Conclusion: The nosocomial infection rate of patients with NSCLC is high, and the main pathogens are Gram-negative bacteria. The proportion of patients with chronic pain after operation is also high. We should pay more attention to the patients with older age, longer hospital stay, low education level, diabetes history and psychological anxiety, and give relevant preventive measures to reduce the incidence of chronic pain after operation.
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