本文選題：喉癌 + 術后��； 參考：《中華醫(yī)院感染學雜志》2017年13期

【摘要】：目的探討喉癌術后醫(yī)院感染相關因素及病原學分析,以期為臨床預防提供依據(jù)。方法選擇2013年1月-2016年6月醫(yī)院手術治療的213例喉癌患者的臨床資料進行分析;分析患者發(fā)生術后感染的相關因素、感染部位分布、病原菌分布以及病原菌耐藥情況。結果 29例患者發(fā)生感染,感染率為13.6%;呼吸系統(tǒng)感染19例,占65.52%,術后感染患者共檢出病原菌50株,其中革蘭陰性菌29株占58.00%,革蘭陽性菌17株占34.00%,真菌4株占8.00%;金黃色葡萄球菌對替考拉寧、萬古霉素敏感;耐甲氧西林金黃色葡萄球菌對奎奴普丁/達福普汀、呋喃妥因、替考拉寧以及萬古霉素敏感;糞腸球菌對哌拉西林+他唑巴坦及萬古霉素敏感;銅綠假單胞菌對哌拉西林他唑巴坦敏感;肺炎克雷伯菌對亞胺培南、美羅培南敏感;大腸埃希菌對哌拉西林他唑巴坦、頭孢曲松、哌拉西林耐藥;年齡≥60歲、病變分期為T3期,營養(yǎng)支持較差,手術時間≥4h,基礎疾病≥2項,接受放化療治療,術后預防使用抗菌藥物治療,術中出血量≥20ml,血清白蛋白≤2.5g/l的患者術后醫(yī)院感染率更高。結論影響喉癌患者術后醫(yī)院感染的因素較多,最常見感染部位為呼吸系統(tǒng),革蘭陰性菌有較高的檢出率,臨床應根據(jù)患者具體情況,積極預防術后感染,對感染患者及時明確病原菌及藥敏結果,使用敏感抗菌藥物治療。
[Abstract]:Objective to investigate the related factors and etiology of nosocomial infection after laryngeal cancer operation, so as to provide evidence for clinical prevention. Methods the clinical data of 213 patients with laryngeal cancer treated by surgery from January 2013 to June 2016 were analyzed, and the related factors of postoperative infection, distribution of infection site, distribution of pathogenic bacteria and drug resistance of pathogenic bacteria were analyzed. Results the infection occurred in 29 patients, the infection rate was 13.60.Respiratory infection was found in 19 patients (65.52%). Among them, 29 strains were Gram-negative bacteria, 17 strains were Gram-positive bacteria, and 4 strains were fungi. Staphylococcus aureus was sensitive to teicoplanin and vancomycin. Teicoplanin and vancomycin; Enterococcus faecalis sensitive to piperacillin and vancomycin; Pseudomonas aeruginosa to piperacillin and tazobactam; Klebsiella pneumoniae to imipenem and meropenem; Escherichia coli was resistant to piperacillin tazobactam, ceftriaxone, piperacillin, age 鈮，

本文編號：1975431