医学毕业论文(呼吸内科) 肺癌化疗患者并下呼吸道感染临床特点及影响因素分析.docVIP

肺癌化疗患者并下呼吸道感染临床特点及影响因素分析 　 　　【摘要】 目的 观察肺癌患者化疗期间合并下呼吸道感染情况，从而为下一步治疗提供有效的预防措施。方法 经病理学或细胞学证实的436例肺癌患者给予铂类为主的化疗，大部分接受4～6个疗程，个别接受6个以上疗程。结果 全组肺癌患者共436例，其中合并下呼吸道感染123例，感染发生率为24.2%。且症状不典型。X线特征为小片状或大片浸润样阴影阻塞性肺炎和肺不张。结论 肺癌患者化疗期间合并下呼吸道感染几率高，且与化疗次数相关联，故在肺癌化疗期间应及早加强免疫支持治疗。 　　【关键词】 肺癌;化学疗法;下呼吸道感染 　　Analysis of clinical features and affecting factors on the patients with lung cancer using chemotherapy complicated with lower respiratory infection 　　JIAO Ke-gang，DAI Yue-mei，SUN Feng，et al.Department of Respiratory Diseases，The First Affiliated Hospital，Xinjiang Medical University，Urunqi 830054，China. 　　[Abstract] Objective To observe the lower respiratory infection status of patients with lung cancer during the period of chemotheraoy，in order to provide the further effective prevention measures for the following treatment.Methods Four hundred and thirty-six patients with lung cancer confirmed by pathology received platinum-based chemotherapy，most of the patients received the chemotherapy for 4～6 cycles，others for more than 6 cycles.Results One hundred and twenty-three patients were complicated with lower respiratory infection with atypical symptoms.The incidence rate of lower respiratory infection was 24.2%.X-rays showed small or big patchy，ill-defined shadowing (obstructive pneumonia or collapsed lung).Conclusion The incidence rate of lower respiratory infection increases in patients with lung cancer using chemotherapy，which is closely associated with the times of treatment.Therefore early stage，immune and support therapy is important in the period of chemotherapy. 　　[Key words] lung cancer;chemotherapy;lower respiratory infection 　　肺癌发病率逐年递增，已成为呼吸系统的常见病，早期诊断困难，确诊时大多数为晚期，化学治疗(简称化疗)是目前治疗肺癌主要方法之一，它使大多数肺癌患者从中受益，但也不可避免地造成患者免疫功能损害，增加了肺部感染机会，明显影响肺癌患者的预后，因此早期诊断和合理治疗具有极其重要意义。现对我院2000年以来肺癌患者伴肺部感染者进行回顾性分析，目的是探讨肺癌患者伴下呼吸道感染的临床特征并指导临床治疗。 　　1 资料与方法 　　1.1 一般资料 2000～2004年我科共收治经组织学或细胞学证实肺癌患者436例，其中123例并发下呼吸道感染，男93例，女30例，年龄36～78岁，平均(62.5±11.8)岁。60岁以上81例，占65.9%。中心型肺癌69.1%(85/123)，周围型30.9%(38/123)。其中