呼吸内科医学论文.doc

肺癌化疗患者并下呼吸道感染临床特点及影响因素分析 作者：焦克岗，戴月梅，孙峰，夏栖，叶汗，祖龙，黄学焕, 齐曼古丽作者单位：830054新疆乌鲁木齐，新疆医科大学第一附属 医院呼吸科 【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例肺癌患者给予钳类为主的化疗，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%o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)是冃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年以來肺癌患 者伴肺部感染者进行冋顾性分析，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