局部晚期非小细胞肺癌合并重症混合性感染个案分析-副本.PDFVIP

736 中国肿瘤临床 2012年第39卷第10期 · · 临床病例讨论 （第21 例） 局部晚期非小细胞肺癌合并重症混合性感染 个案分析 ① ② ① ③ ① 赵晓亮 林 丽 陈玉龙 肖建宇 王长利 局部晚期非小细胞肺癌患者由于病情复杂及自身状况较差，是重症或混合性感染高发人群，主要原因为多存有重症 摘要： 感染的高危因素，包括长期吸烟史、常罹患糖尿病、慢性阻塞性肺病，肺阻塞及膨胀不良等造成肺部自洁功能下降，以及外科手 术、放疗、化疗等相关治疗和药物对机体造成的免疫抑制等。肺癌合并重症感染临床表现多样，原因机制复杂，病情进展迅速，预 后差。临床治疗上缺乏完善的疗效评价体系，存在临床及影像学上变化不同步，同时需与多种疾病相鉴别。现介绍天津医科大 学附属肿瘤医院肺部肿瘤科2011年3月收治的1例经多学科综合治疗的局部晚期非小细胞肺癌合并重症混合性感染的病例。该 患者化疗过程中出现重症混合性肺感染，经综合治疗后效果较佳。同时探讨肺癌合并重症混合性感染的鉴别诊断和治疗规范。 关键词 非小细胞肺癌 重症感染 治疗原则 doi:10.3969/j.issn.1000-8179.2012.10.027 A Case Study of Locally Advanced Non-small Cell Lung Cancer with Severe Mixed Infections: Differential Diagnosis and Treatment 1 2 1 3 1 Xiaoliang ZHAO , Li LIN , Yulong CHEN , Jianyu XIAO , Changli WANG Correspondence to: Changli WANG; E-mail: wangchangli@ 1Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China 2Department of Medical Oncology on Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China 3Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China Abstract Patients with locally advanced non-small cell lung cancer are high-risk populations who usually suffer from severe or mixed infections because of their complex body conditions. The main causes of severe infections in patients with high risk factors include smoking history, diabetes, chronic obstructive pulmonary disease, and pulmonary congestion and swelling caused by the decline in lung self-cleaning functions. Other possible causes include surgical operations, radiotherapy, chemotherapy, and other treatments and medications that can result in the i