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目的 :探索肺癌伴下呼吸道感染时病原学及其意义。 方法 :研究 1985～ 1998年间肺癌伴下呼吸道感染患者细菌学特征和临床特征。结果 :(1) 2 92 8例肺癌患者伴发感染 12 11例 (4 1.36 % ) ,大细胞肺癌 (5 1.71% )和小细胞肺癌 (4 8.81% )感染发生率高于腺癌 (38.93% )和鳞癌感染 (35 .2 7% ) (P<0 .0 1) ;早期肺癌感染发生率 ( 期 8.38% , 期 18.30 % )明显低于晚期肺癌 ( 期 44 .72 % , 期 49.92 % ) (P<0 .0 1)。(2 )分离细菌 880株 ,革兰阴性细菌占 70 .91% ,绿脓杆菌、不动杆菌、肺炎杆菌、表皮葡萄球菌、金黄色葡萄球菌居前 5位。(3)药敏试验提示 ,绿脓杆菌、不动杆菌、黄杆菌、D群非肠球菌等出现高比例、多重耐药。革兰阴性菌对头孢噻甲羧肟、依米配能、氨基糖甙类、喹喏酮类较为敏感。革兰阳性菌则对万古霉素高度敏感。 结论 :肺癌伴下呼吸道感染与肺癌的组织类型、临床分期密切相关 ,病原以革兰阴性杆菌为主 ,且存在多重耐药 ;治疗时应根据药敏试验结果选择药物 ,同时加强综合治疗。
Objective: To explore the etiology and significance of lung cancer associated with lower respiratory tract infection. Methods : To study the bacteriological characteristics and clinical features of patients with lung cancer associated with lower respiratory tract infection from 1985 to 1998. RESULTS: (1) Of the 928 cases of lung cancer, 1211 (41.36%) were associated with infection, and the incidence of large cell lung cancer (51.71%) and small cell lung cancer (48.81%) was higher than that of adenocarcinoma (38.93%). ) and squamous cell carcinoma (35.27%) (P < 0.01); the incidence of early stage lung cancer (8.38%, 18.3%) was significantly lower than that of advanced stage lung cancer (44.72%, period 49.92%). ) (P<0. 0 1). (2) 880 strains of bacteria were isolated, Gram-negative bacteria accounted for 70.91%, and the top five were Pseudomonas aeruginosa, Acinetobacter, Klebsiella, Staphylococcus epidermidis, and Staphylococcus aureus. (3) Drug susceptibility test indicated that Pseudomonas aeruginosa, Acinetobacter spp., Flavobacterium and non-enterococci of group D appeared high proportion and multidrug resistance. Gram-negative bacteria are more sensitive to ceftazidime, imipenem, aminoglycosides and quinolones. Gram-positive bacteria are highly sensitive to vancomycin. Conclusion: Lung cancer associated with lower respiratory tract infection is closely related to the tissue type and clinical stage of lung cancer. Gram-negative bacilli are the main pathogens, and there are multiple drug resistances. Drugs should be selected based on drug sensitivity test results, and comprehensive treatment should be strengthened.