目的 对比肝胆恶性肿瘤患者胆道混合菌感染与单一菌感染对患者造成的损失的差异。方法 选取天津医科大学肿瘤医院2017年1月—2019年12月诊断为肝胆恶性肿瘤且发生胆道感染的患者，按胆汁培养病原菌种数分为混合菌感染组和单一菌感染组，收集病例相关信息，采用倾向性得分匹配法（PSM）对两组患者进行1∶1配对，配对成功后，采用配对样本秩和检验和配对样本t检验的方法对两组患者的住院天数、住院费用、用抗菌药天数、抗菌药费用、抗菌药用药频度（DDDs）进行分析。结果 最终匹配成功32对，混合菌感染组患者住院天数中位数为25.00 d；单一菌感染组患者住院天数中位数为14.50 d，两组具有显著性差异（P<0.05）；混合菌感染组患者住院总费用中位数为46 779.78元；单一菌感染组患者住院总费用中位数为35 512.73元，两组具有显著性差异（P<0.05）；混合菌感染组患者用抗菌药天数中位数为13.00 d；单一菌感染组患者用抗菌药天数中位数为11.00 d，两组具有显著性差异（P<0.05）；混合菌感染组患者抗菌药费用中位数为5 396.91元；单一菌感染组患者抗菌药费用中位数为3 200.94元，两组具有显著性差异（P<0.05）；混合菌感染组抗菌药DDDs为62.38±36.63，单一菌感染组抗菌药DDDs为49.78±17.86，两组具有显著性差异（P<0.05）。结论 肝胆恶性肿瘤胆道混合菌感染导致患者住院时间、抗菌药应用时间延长，住院费用、抗菌药费增加、抗菌药DDDs增加，因此，降低混合菌感染率至关重要。

Objective To compare the difference of patients losses caused by mixed bacterial infection and single bacterial infection in patients with hepatobiliary malignancies.Methods Patients diagnosed with hepatobiliary malignant tumor and biliary tract infection in Cancer Hospital of Tianjin Medical University from January 2017 to December 2019 were selected and divided into mixed bacteria infection group and single bacteria infection group according to the number of pathogenic bacteria in bile culture. The relevant information of cases was collected, and the PSM propensity score matching method was used for 1∶1 matching between the two groups. After successful matching, the paired sample rank sum test and paired sample t test were used to analyz the length of stay, hospitalization expenses, days of using antibiotics, cost of antibiotics and DDDs were analyzed.Results The final match was successful in 32 pairs, the median length of stay in the mixed bacteria infection group was 25.00 days; the median hospitalization days in the single bacteria infection group was 14.50 days, with significant difference between the two groups (P<0.05); the median hospitalization expenses of the mixed bacteria infection group was 46 779.78 yuan; the median hospitalization expenses of the single bacteria infection group was 35 512.73 yuan, which was significant between the two groups. The difference was statistically significant (P<0.05); the median days of using antibiotics in mixed bacteria infection group was 13.00 days, the median days of single bacteria infection group was 11.00 days, with significant difference between the two groups (P<0.05), the median cost of antibiotics in mixed bacteria infection group was 5 396.91 yuan, the median cost of antibiotics in single bacteria infection group was 3 200.94 yuan, with significant difference between the two groups. The difference was statistically significant (P<0.05), the DDDs of mixed bacteria infection group was 62.38 ±36.63, and that of single bacteria infection group was 49.78 ±17.86, with significant difference between the two groups (P<0.05).Conclusion The infection of mixed bacteria in biliary tract of patients with hepatobiliary malignant tumor leads to the prolongation of hospitalization time, the application time of antibiotics, the increase of hospitalization expenses, the increase of antibiotics expenses, and the increase of DDDs of antibiotics. Therefore, it is very important to reduce the infection rate of mixed bacteria.

R979.1

国家自然科学基金资助项目（81703454）