摘要
目的:观察鼻咽癌同步放化疗患者治疗前后的营养状况和院内感染情况,探讨预防感染的有效措施。方法:对82例鼻咽癌接受同步放化疗的患者治疗前后的营养状况以及院内感染和治疗情况进行回顾性分析。结果:同步放化疗前后患者营养状况,包括体重、血红蛋白及血清白蛋白之间差异有统计学意义。82例患者中发生院内感染者63例(76.83%);口鼻、咽部黏膜感染者76例(92.68%);黏膜感染伴有皮肤带状疱疹者2例(2.44%);肺部感染者3例(3.66%);败血症1例(1.22%)。共分离病原菌39株,病原菌其中革兰阴性菌最为多见,共23株(58.97%);其次真菌12株(30.77%);革兰阳性菌3株(7.69%);带状疱疹病毒1株(2.56%)。结论:晚期鼻咽癌同步放化疗患者治疗期间应做好营养监测和营养支持,加强饮食指导和干预以减少其不良反应的发生,提高患者的躯体耐受性及生活质量。同期放化疗期间院内感染以口咽黏膜感染革兰阴性菌发生率最高,应重视咽拭子培养,必须加强口腔护理并合理用药。
Objective：To analyze the nutritional status and nosocomial infection of nasopharyngeal carcinoma patients before and after the chemoradiotherapeutical treatment. Method： An analysis was made for the nutritional and nosocomial infection status of 82 cases before and after chemoradiotherapeutical treatment. Result：Statistically significant differences were revealed between indexes related with nutritional status such as body mass, hemoglo- bin, serum albumin before and after the treatment. Sixty-three patients occured nosocomial infection. The infection rate was 76.83%. The main risk factor was oropharynx mucosal lesion and the rate is 92.68%. Isolates of 39 bac- teria were found, of which Gram-negative organisms were 58. 97% ,Fungi were 30.77 %, Gram-positive ones were 7.69%, Herpes zoster were 2.56 %. Conclusion：Chemoradiotherapy has negative influence on nutritional status of patients. Medical personnel should pay attention to patients ＇ nutritional status and do a good job of nutritional sta- tus monitoring, nutrition support, dieting guidance, reducing side effects, in order to improve the patient＇s tolera- bility and quality of life. The nosocomial infection rate of Gram-negative bacteria of oropharyngeal mucosal is the highest in patients with advanced nasopharyngeal cancer during chemoradiotherapy. It is very important for us to prevent and control nosocomial infection.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2014年第3期188-191,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
衡阳市基础(应用)研究项目(No:2012KJ45)
关键词
鼻咽肿瘤
放射治疗
化学治疗
营养状况
院内感染
nasopharyngeal neoplasms
radiation chemo therapy
nutritional status
nosocomial infection
