Analysis of the nutritional status and nosocomial infection during chemoradiotherapy in advanced nasopharyngeal carcinoma patients
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摘要: 目的:观察鼻咽癌同步放化疗患者治疗前后的营养状况和院内感染情况,探讨预防感染的有效措施。方法:对82例鼻咽癌接受同步放化疗的患者治疗前后的营养状况以及院内感染和治疗情况进行回顾性分析。结果:同步放化疗前后患者营养状况,包括体重、血红蛋白及血清白蛋白之间差异有统计学意义。82例患者中发生院内感染者63例(76.83%);口鼻、咽部黏膜感染者76例(92.68%);黏膜感染伴有皮肤带状疱疹者2例(2.44%);肺部感染者3例(3.66%);败血症1例(1.22%)。共分离病原菌39株,病原菌其中革兰阴性菌最为多见,共23株(58.97%);其次真菌12株(30.77%);革兰阳性菌3株(7.69%);带状疱疹病毒1株(2.56%)。结论:晚期鼻咽癌同步放化疗患者治疗期间应做好营养监测和营养支持,加强饮食指导和干预以减少其不良反应的发生,提高患者的躯体耐受性及生活质量。同期放化疗期间院内感染以口咽黏膜感染革兰阴性菌发生率最高,应重视咽拭子培养,必须加强口腔护理并合理用药。Abstract: Objective:To analyze the nutritional status and nosocomial infection of nasopharyngeal carcinoma patients before and after the chemoradiotherapeutical treatment.Method:An analysis was made for the nutritional and nosocomial infection status of 82 cases before and after chemoradiotherapeutical treatment.Result:Statistically significant differences were revealed between indexes related with nutritional status such as body mass, hemoglobin, serum albumin before and after the treatment.Sixty-three patients occured nosocomial infection. The infection rate was 76.83%. The main risk factor was oropharynx mucosal lesion and the rate is 92.68%. Isolates of 39 bacteria were found, of which Gram-negative organisms were 58.97%,Fungi were 30.77%, Gram-positive ones were 7.69%, Herpes zoster were 2.56%.Conclusion:Chemoradiotherapy has negative influence on nutritional status of patients. Medical personnel should pay attention to patients ' nutritional status and do a good job of nutritional status monitoring, nutrition support, dieting guidance, reducing side effects, in order to improve the patient 's tolerability and quality of life. The nosocomial infection rate of Gram-negative bacteria of oropharyngeal mucosal is the highest in patients with advanced nasopharyngeal cancer during chemoradiotherapy. It is very important for us to prevent and control nosocomial infection.
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Key words:
- nasopharyngeal neoplasms /
- radiation chemo therapy /
- nutritional status /
- nosocomial infection /
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[1] 李菊.鼻咽癌同步放化疗过程中不良反应观察与处理[J].现代医药卫生, 2008, 24 (4):574-575.
[2] 中国鼻咽癌临床分期工作委员会.鼻咽癌'92分期修订工作报告[J].中华放射肿瘤学杂志, 2009, 18 (1):2-6.
[3] 殷蔚伯, 余子豪, 徐国镇, 等.肿瘤放射治疗学[M].北京:中国协和医科大学出版社, 2008:149-150.
[4] DEMIZU Y, SASAKI R, SOEJIMA T, et al.Efficacy and feasibility of cisplatin-based concurrent chemoradiotherapy for nasopharyngeal carcinoma[J].Jpn J Clin Oncol, 2006, 36:620-625.
[5] 高凤莉, 陈伟, 鲁重美.肿瘤患者的营养不良状况及其相关因素研究进展[J].中国肿瘤临床与康复, 2008, 15 (1):80-82.
[6] 谢玉琼, 邱宝珊.鼻咽癌放疗后营养失调相关因素的分析[J].临床医学工程, 2009, 16 (5):103-105.
[7] 冯惠霞, 钟文欢, 蒋红花, 等.诱导化疗加同期放化疗治疗局部晚期鼻咽癌的临床观察及护理[J].全科护理, 2010, 8 (10):847-849.
[8] 吴婉英, 谢淑萍.晚期鼻咽癌同步放化疗患者营养状况监测分析[J].护理学报, 2009, 16 (18):57-58.
[9] 黄卫红, 袁烨.饮食管理对鼻咽癌患者放疗期间营养状况的影响[J].当代护士, 2010, 7 (1):42-43.
[10] 谢建忠, 薛福英, 黄彬, 等.肿瘤患者医院感染病原菌分布与抗菌药物耐药分析[J].中国预防医学杂志, 2010, 11 (2):139-143.
[11] 谢源福, 黄建丽, 林坤花, 等.重组人粒-巨噬细胞集落刺激因子治疗头颈肿瘤放疗所致口腔黏膜炎40例[J].肿瘤研究与临床, 2008, 20 (4):273-274.
[12] LEE A W, TUNG S Y, CHAN A T, et al.Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma[J].Int J Radiat Oncol Biol Phys, 2006, 66:142-151.
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