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目的:探讨大肠癌患者术后中心静脉导管(CVC)真菌感染的相关因素,寻求有效的预防改进措施。方法:回顾性分析100例住院的大肠癌手术患者(手术组)留置CVC的感染情况,并分析感染的相关因素。与同时期62例术后化疗患者(化疗组)留置CVC的感染情况进行比较。结果:手术组中7例(7.00%)发生CVC相关性真菌感染,其中6例单纯CVC感染,1例同时合并真菌血症。7例患者均为念珠菌感染,主要为近平滑念珠菌57.1%(4/7)。其感染与术后并发吻合口瘘有关,而与患者年龄、性别、手术方式、肿瘤大小、分期、导管留置时间和置管位置无关。6例患者拔除CVC后感染自愈,1例真菌血症患者抗真菌治疗后痊愈。化疗组没有患者发生导管相关真菌感染,与手术组感染率相比差异有统计学意义,P<0.05。结论:大肠癌手术后CVC相关真菌感染的主要病原菌是近平滑念珠菌,吻合口瘘可能是其高危因素,及时拔除感染的CVC,可有效地防治导管相关的血行感染。
Objective: To investigate the related factors of fungal infection of central venous catheter (CVC) in patients with colorectal cancer and to seek effective preventive measures. Methods: A retrospective analysis of 100 cases of hospitalized patients with colorectal cancer surgery (surgical group) indwelling CVC infection, and analysis of infection-related factors. Compared with the 62 cases of postoperative chemotherapy patients (chemotherapy group) CVC infection. Results: In the operation group, 7 cases (7.00%) had CVC-associated fungal infection, of which 6 cases had CVC infection alone and 1 case complicated with fungal exacerbation. All 7 patients were Candida infections, mainly 57.1% (4/7) Candida parapsilosis. The infection and postoperative complications associated with anastomotic leakage, but with age, gender, operation, tumor size, stage, catheter indwelling time and catheter placement has nothing to do. Six patients were self-healing after removal of CVC, and one patient with fungal sepsis recovered after antifungal therapy. No catheter-related fungal infection occurred in patients in the chemotherapy group, which was significantly different from the infection rate in the operation group (P <0.05). Conclusion: The main pathogen of CVC-associated fungal infection after colorectal cancer surgery is Candida parapsilosis. Anastomotic fistula may be the risk factor for timely removal of infected CVC, which can effectively prevent and treat catheter-related bloodstream infections.