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目的探索肿瘤患者在治疗过程中真菌感染发生的危险因素。方法查阅中国生物医学文献数据库、CNKI、万方等中文数据库,对肿瘤患者真菌感染的发生相关文献进行收集;搜索的关键字包括肿瘤、真菌感染、影响因素,并追索已纳入的参考文献,对文献进行评价与资料提取,使用Rev Man5.3与Stata11软件进行meta分析。结果累计检索到527篇文献,根据纳入和排除标准最终纳入12篇文献,其中病例组899例,对照组2,202例。分析结果显示高龄(OR=1.90,95%CI:2.43~2.52)、肿瘤分期较晚(OR=2.50,95%CI:1.73~3.60)、PS评分较高(OR=2.09,95%CI:1.33~3.29)、白细胞计数较低(OR=2.49,95%CI:1.94~3.20)、放疗中伴有糖皮质激素的使用(OR=1.74,95%CI:1.32~2.29)、合并基础疾病(OR=5.35,95%CI:1.94~14.75)、术后高血糖(OR=3.10,95%CI:1.70~5.66)、接受了侵入性操作(OR=3.34,95%CI:1.06~10.58)、住院时间较长(OR=1.36,95%CI:1.16~1.61)是接受放化疗后真菌感染发生的危险因素。结论影响肿瘤患者真菌感染的主要因素包括个体的免疫力与医疗服务,需加强院内感染患者的个体关注与院内感染的监测,以减少肿瘤患者真菌感染的发生于病死。
Objective To explore the risk factors of fungal infection in cancer patients during treatment. Methods The Chinese literature of Chinese biomedical literature database, CNKI and Wanfang were searched to collect the relevant literature on the occurrence of fungal infections in cancer patients. The keywords of the search included tumor, fungal infection and influencing factors, and recalled references, Document evaluation and data extraction, meta-analysis using RevMan5.3 and Stata11 software. Results A total of 527 articles were retrieved, and 12 articles were finally included according to inclusion and exclusion criteria, of which 899 were in the case group and 2,202 in the control group. The results of the analysis showed that the older the patients were (OR = 1.90, 95% CI: 2.43-2.52), the later the tumor staging was (OR = 2.50,95% CI: 1.73-3.60) ~ 3.29), low white blood cell count (OR = 2.49, 95% CI: 1.94-3.20), and the use of glucocorticoid in radiotherapy (OR = 1.74,95% CI: 1.32-2.29) (OR = 3.34, 95% CI: 1.06-10.58), hospitalization (OR = 3.34, 95% CI: 1.94-14.75) and postoperative hyperglycemia (OR = 3.10, 95% CI: 1.70-5.66) A longer duration (OR = 1.36, 95% CI: 1.16-1.61) was a risk factor for fungal infection after chemoradiation. Conclusion The main factors influencing fungal infections in cancer patients include individual immunity and medical services. Individual attention and nosocomial infection in patients with nosocomial infections should be monitored to reduce the incidence of fungal infections in patients with cancer.