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为了确定肺部感染对肺癌病人存活的影响,作者回顾性分析了1984年1月～1986年12月间收治的121例这种病例记录。男性77例,女性44例,平均年龄63.5岁,其中鳞癌43例,腺癌31例,大细胞癌18例,小细胞癌19例,10例未分类。分期,0期2例,Ⅰ期15例,Ⅱ期7例,Ⅲ期45例,Ⅳ期44例,8例诊断时未能分期。确定肺部感染的标准分为主要和次要两类。主要标准是:(1)胸片上强烈提示感染;(2)痰中查到大量细菌。次要标准是:(1)发热38.3℃以上至少48小时,无其它原因解释;(2)出现新的症状,如咳嗽、咳痰或胸痛;(3)中性粒细胞增多。如果病人有两条主要标准和全部次要标准,或至少有一条主要标准和一条次要标准,就定为有肺部感染。按此标准,结果发现85例(70%)有感染,37例(44%)只有一次感染,48例(55%)有多次感染。72例(60%)找到细菌,最常的是 a/r 链球菌,其次是金色葡萄球菌,肺炎杆菌、肠产气杆菌和绿脓杆菌。病人用各种抗生素治疗,包括头孢唑咻,青霉素、氨苄青霉素和氮基甙类。结果发现所有感染者平均存活4.2月,显著短于无感染者,后者平均存活12.9月(P<0.05)。一次
In order to determine the effect of lung infection on survival of lung cancer patients, the author retrospectively analyzed 121 cases of such cases recorded between January 1984 and December 1986. There were 77 males and 44 females with an average age of 63.5 years, of which 43 were squamous cell carcinoma, 31 were adenocarcinoma, 18 were large cell carcinoma, 19 were small cell carcinoma, and 10 were unclassified. Stages included 2 cases in phase 0, 15 in stage I, 7 in stage II, 45 in stage III, and 44 in stage IV. Eight cases failed to be staged during diagnosis. The criteria for determining lung infections are divided into major and minor categories. The main criteria are: (1) Strongly suggestive of infection on the chest radiograph; (2) A large number of bacteria are found in the sputum. The secondary criteria are: (1) Fever at 38.3°C for at least 48 hours without explanation for other reasons; (2) New symptoms such as cough, sputum, or chest pain; (3) Neutrophil increase. If the patient has two major criteria and all secondary criteria, or at least one major criterion and one minor criterion, there is a pulmonary infection. According to this standard, 85 (70%) had infection, 37 (44%) had only one infection, and 48 (55%) had multiple infections. Bacteria were found in 72 cases (60%), most commonly a/r streptococci, followed by Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter enteritidis, and Pseudomonas aeruginosa. The patient was treated with a variety of antibiotics, including ceftizoxime, penicillin, ampicillin, and nitrogen-based steroids. The results showed that the average survival of all infected persons was 4.2 months, which was significantly shorter than those without infection, and the latter survived for an average of 12.9 months (P<0.05). once