| 高 非,何 茵,鹿振辉,石 颖,蔺 珊,张葆勋.肺癌术后并发肺部感染的病原菌分布及影响因素的回顾性研究[J].,2022,(12):2255-2259 |
| 肺癌术后并发肺部感染的病原菌分布及影响因素的回顾性研究 |
| Retrospective Study on Pathogenic Bacteria Distribution and Influencing Factors of Postoperative Pulmonary Infection in Lung Cancer |
| 投稿时间：2021-12-06 修订日期：2021-12-28 |
| DOI：10.13241/j.cnki.pmb.2022.12.011 |
| 中文关键词: 肺癌 肺部感染 病原菌 影响因素 回顾性研究 |
| 英文关键词: Lung cancer Pulmonary infection Pathogenic bacteria Influencing factors Retrospective study |
| 基金项目:北京市医院管理局"青苗"计划项目（QML20180206） |
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| 中文摘要: |
| 摘要 目的：观察肺癌术后并发肺部感染患者的病原菌分布特点，并分析导致感染的影响因素。方法：分析我院2018年3月~2020年12月期间收治的肺癌患者（n=358）的临床资料，统计肺癌术后并发肺部感染例数，并据此分为感染组和未感染组，观察感染患者病原菌分布特点，探讨引起感染的危险因素。结果：358例肺癌患者中，有32例患者出现术后肺部感染，感染率为8.94%。32例感染患者共分离出病原菌株49株，其中革兰阴性菌31株，占比63.27%。革兰阳性菌15株，占比30.61%。真菌3株，占比6.12%。其中前五位分别为肺炎克雷伯菌24.49%、阴沟肠杆菌14.29%、金黄色葡萄球菌12.24%、铜绿假单胞菌10.20%、鲍曼不动杆菌10.20%。单因素及多因素Logistic回归分析结果显示：术后肺部感染与长期吸烟史、手术方式、切口疼痛评分、慢性阻塞性肺疾病史、年龄、手术时间、糖尿病史有关（P<0.05）；肺癌患者术后并发肺部感染的危险因素包括慢性阻塞性肺疾病史、切口疼痛评分4~6分、长期吸烟史、糖尿病史、年龄≥60岁、手术方式为常规手术、手术时间≥3 h（P<0.05）。结论：切口疼痛评分、长期吸烟史、慢性阻塞性肺疾病史、年龄、手术时间、糖尿病史、手术方式均是导致肺癌术后并发肺部感染的危险因素，可针对上述因素采取积极处理措施，肺癌术后并发肺部感染的病原菌以革兰阴性菌为主，临床应给予合理的预防性抗生素进行治疗。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the pathogenic bacteria distribution characteristics in postoperative pulmonary infection in patients with lung cancer, and to analyze the influencing factors of infection. Methods: From March 2018 to December 2020, the clinical datas of patients with lung cancer (n=358) who were treated in our hospital were analyzed. The number of postoperative pulmonary infection in patients with lung cancer was counted, and they were divided into infected group and uninfected group according to this. The pathogenic bacteria distribution characteristics were observed, and the risk factors of infection were discussed. Results: Among 358 patients with lung cancer, 32 patients developed postoperative pulmonary infection, with an infection rate of 8.94%. 49 s of pathogenic bacteria were isolated from 32 cases of postoperative pulmonary infection in patients with lung cancer, including 31 strains of Gram-negative bacteria, accounting for 63.27%. 15 strains of gram-positive bacteria accounted for 30.61%. 3 strains of fungi, accounting for 6.12%. The top five were Klebsiella pneumoniae with 24.49%, Enterobacter clovis with 14.29%, Staphylococcus aureus with 12.24%, Pseudomonas aeruginosa with 10.20% and Acinetobacter baumannii with 10.20%. Univariate and multivariate logistic regression analysis showed that postoperative pulmonary infection was associated with long-term smoking history, operation method, incision pain score, chronic obstructive pulmonary disease history, age, operation time and diabetes mellitus history (P<0.05). The risk factors of postoperative pulmonary infection in patients with lung cancer included chronic obstructive pulmonary disease history, incision pain score 4~6 scores, long-term smoking history, diabetes mellitus history, age ≥60 years, the operation method was routine operation, operation time ≥3 h (P<0.05). Conclusion: Incision pain score, long-term smoking history, chronic obstructive pulmonary disease history, age, operation time, diabetes mellitus history, and operation method are all risk factors for postoperative pulmonary infection in patients with lung cancer, and active measures can be taken to deal with these factors, gram-negative bacteria are the main pathogens of postoperative pulmonary infection in patients with lung cancer, and reasonable preventive antibiotics should be given for clinical treatment. |
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