临床护理杂志
臨床護理雜誌
림상호리잡지
Journal of Clinical Nursing
2015年
5期
18-21
,共4页
头颈部肿瘤%西妥昔单抗注射液%口咽细菌感染
頭頸部腫瘤%西妥昔單抗註射液%口嚥細菌感染
두경부종류%서타석단항주사액%구인세균감염
head and neck neoplasms%cetuximab solution for infusion%oropharyngeal bacterial infections
目的：探讨头颈部肿瘤患者放疗期间口咽部细菌感染风险的相关因素及护理干预措施。方法选择2013年5月～2014年5月我科收治的122例头颈部肿瘤患者放疗期间的咽拭子细菌培养结果进行分析，有序Logistic多因素回归模型探讨感染菌种数的相关影响因素。结果放疗期间咽拭子细菌阳性患者60例，占49．2％。50例检测到一种细菌，9例检测到2种细菌，1例检测到3种细菌。最多见的细菌为金葡菌，其次为肺炎克雷伯菌、鲍曼不动杆菌、阴沟长杆菌、铜绿假单胞菌等。多因素分析结果显示，使用西妥昔单抗、年龄及T分期是影响口腔感染菌种数量的显著因素。结论使用西妥昔单抗，年龄及T分期可能增加头颈部肿瘤患者放疗期间口咽部多重感染的风险。针对感染高危患者应采取相应的护理措施。
目的：探討頭頸部腫瘤患者放療期間口嚥部細菌感染風險的相關因素及護理榦預措施。方法選擇2013年5月～2014年5月我科收治的122例頭頸部腫瘤患者放療期間的嚥拭子細菌培養結果進行分析，有序Logistic多因素迴歸模型探討感染菌種數的相關影響因素。結果放療期間嚥拭子細菌暘性患者60例，佔49．2％。50例檢測到一種細菌，9例檢測到2種細菌，1例檢測到3種細菌。最多見的細菌為金葡菌，其次為肺炎剋雷伯菌、鮑曼不動桿菌、陰溝長桿菌、銅綠假單胞菌等。多因素分析結果顯示，使用西妥昔單抗、年齡及T分期是影響口腔感染菌種數量的顯著因素。結論使用西妥昔單抗，年齡及T分期可能增加頭頸部腫瘤患者放療期間口嚥部多重感染的風險。針對感染高危患者應採取相應的護理措施。
목적：탐토두경부종류환자방료기간구인부세균감염풍험적상관인소급호리간예조시。방법선택2013년5월～2014년5월아과수치적122례두경부종류환자방료기간적인식자세균배양결과진행분석，유서Logistic다인소회귀모형탐토감염균충수적상관영향인소。결과방료기간인식자세균양성환자60례，점49．2％。50례검측도일충세균，9례검측도2충세균，1례검측도3충세균。최다견적세균위금포균，기차위폐염극뢰백균、포만불동간균、음구장간균、동록가단포균등。다인소분석결과현시，사용서타석단항、년령급T분기시영향구강감염균충수량적현저인소。결론사용서타석단항，년령급T분기가능증가두경부종류환자방료기간구인부다중감염적풍험。침대감염고위환자응채취상응적호리조시。
Objective To analyze whether radiotherapy combined with cetuximab correlates with increased risk of bacte‐ria infection in head and neck cancer patients and to explore the nursing countermeasures for radiation-induced oral mucosi‐tis .Methods The throat swab specimens were obtained from 122 head and neck patients during IMRT course at our hospi‐tal from may 2013 to may 2014 .The clinically relevant factors for the bacteria-positive throat swab cultures were evaluated for their predictive effect using the ordered logistic regression .Results A total of 60 cases (49 .2% ) presented positive results of throat swab cultures for pathogenic bacte‐ria during radiotherapy course .One type of bacteria was de‐tected in 50 cases ,two types in 9 cases ,and three types in 1 case .The most common type of pathogenic bacteria was staphylococcus aureus ,followed by klebsiella pneumoniae ,baumanii ,bacillus cloacae and pseudomonas aeruginosa .Age ,T stage and administration of cetuximab were found to be the most significant predictors for oral and pharyngeal bacteria infec‐tion .Conclusions Older age ,advanced T stage and the usage of cetuximab can significantly increase the risk of oropharynx bacteria infection in head and neck cancer patients during radiotherapy .The corresponding nursing countermeasures need to be taken for patients with high risk of developing radiation-induced bacterial oral mucositis .
