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目的探讨晚期乳腺癌化疗后呼吸道感染的危险因素,为预防其呼吸道感染提供依据。方法分析医院肿瘤科2005年2月-2012年9月171例晚期乳腺癌患者行含铂方案化疗后呼吸道感染的发生率及病原菌分布,并采用logistic回归模型分析晚期乳腺癌患者含铂方案化疗后呼吸道感染的危险因素。结果 171例晚期乳腺癌患者含铂方案化疗后共有55例发生呼吸道感染,占32.16%,其中上呼吸道感染18例,下呼吸道感染37例;检出革兰阳性菌26株占47.27%,革兰阴性菌27株占49.09%,真菌2株占3.64%,排在前3位的病原菌依次为肺炎链球菌、肺炎克雷伯菌和大肠埃希菌;呼吸道感染危险因素有年龄、肺转移、KPS评分、化疗周期、白蛋白、住院时间、化疗方案、联合放疗和抗菌药物使用种类。结论晚期乳腺癌含铂方案化疗后呼吸道感染的发生率较高,以下呼吸道感染为主,主要病原菌为革兰阳性菌和革兰阴性菌,且该类患者呼吸道感染的危险因素较多,应根据患者具体病情进行及时预防。
Objective To investigate the risk factors of respiratory tract infection after chemotherapy for advanced breast cancer and provide basis for prevention of respiratory tract infection. Methods A total of 171 patients with advanced breast cancer who underwent platinum-based chemotherapy were enrolled in this study from February 2005 to September 2012. The incidences of respiratory tract infections and pathogenic bacteria distribution in patients with advanced breast cancer were analyzed by logistic regression model. Risk factors for respiratory infections. Results 171 patients with advanced breast cancer after platinum-containing regiment chemotherapy occurred in 55 cases of respiratory tract infection, accounting for 32.16%, of which 18 cases of upper respiratory tract infection, 37 cases of lower respiratory tract infection; Gram-positive bacteria were detected in 26 strains accounted for 47.27% 27 strains of negative bacteria accounted for 49.09% and 2 strains of fungi accounted for 3.64%. The top three pathogenic bacteria were Streptococcus pneumoniae, Klebsiella pneumoniae and Escherichia coli. The risk factors of respiratory infection were age, lung metastasis, KPS Score, cycle of chemotherapy, albumin, length of stay, chemotherapy regimen, combination radiotherapy, and type of antimicrobial use. Conclusions The incidence of respiratory tract infections in patients with advanced breast cancer after platinum-containing chemotherapy is high, with the following respiratory infections as main pathogens as Gram-positive bacteria and Gram-negative bacteria. There are more risk factors for respiratory infections in these patients. Patients with specific conditions for timely prevention.