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目的探讨乳腺癌患者根治术化疗后继发感染的分布情况和病原菌特点。方法选取2015年1月至2016年12月间在该院行乳腺癌患者根治术AC-T方案化疗后继发感染患者58例,采集患者感染部位标本,主要包括:咽拭子、溃疡组织、皮肤渗出液、血液、尿液等,常规进行细菌分离、培养、鉴定;对感染情况进行统计分析,记录各化疗周期感染发生率以及院内和院外感染情况,同时观察感染发生部位。结果治疗后1 w内有15次感染,1~w内19次感染,3~w内22次感染,4~6 w内10次感染;其中40次感染发生在医院外,25次感染发生在住院期间,院外感染的发生率明显高于院内感染,差异有统计学意义(P<0.05)。化疗后的65次感染中,以呼吸道感染比例最高,消化道感染次之,与其他部位感染比较差异有统计学意义(P<0.05)。革兰阴性菌、革兰阳性菌、真菌的检出率依次为45.97%、18.55%、35.48%,革兰阴性菌检出率明显高于革兰阳性菌、真菌,差异有统计学意义(均P<0.05)。结论乳腺癌患者根治术化疗后易发生院外感染,感染致病菌以革兰阴性菌为主,呼吸道和消化道为感染的高发部位。
Objective To investigate the distribution of secondary infection and pathogenic bacteria in patients with breast cancer after radical surgery. Methods From January 2015 to December 2016, 58 patients with secondary infection after radical mastectomy for breast cancer undergoing AC-T chemotherapy were enrolled in this hospital from January 2015 to December 2016. Samples of the infected area were collected, including throat swab, ulcer tissue, skin Exudates, blood, urine and so on. Bacteria were routinely isolated, cultured and identified. Statistical analysis of infection was carried out to record the incidence of each chemotherapy cycle infection and hospital and extra-hospital infection, and to observe the infection site. Results There were 15 infections within 1 w after treatment, 19 infections within 1 to w, 22 infections within 3 to w and 10 infections within 4 to 6 w. Of the 40 infections that occurred outside the hospital, 25 infections occurred in During hospitalization, the incidence of nosocomial infections was significantly higher than that of nosocomial infections, the difference was statistically significant (P <0.05). Among the 65 infections after chemotherapy, the highest proportion of respiratory infections, followed by gastrointestinal infections, and other parts of the infection was significantly different (P <0.05). Gram-negative bacteria, Gram-positive bacteria, fungi were detected in 45.97%, 18.55%, 35.48%, Gram-negative bacteria was significantly higher than Gram-positive bacteria, fungi, the difference was statistically significant P <0.05). Conclusions After radical chemotherapy in patients with breast cancer, an out-of-hospital infection is likely to occur. Gram-negative bacteria are the main pathogens causing infection. The respiratory and digestive tract are the most common infectious diseases.