危重病监护病房内粒细胞缺乏患者的临床特征及综合性治疗  

Clinical feature and conbined therapy of the patients with Neutropenia syndrome in intensive care unit

作　　者：刘卫江[1] 温德良[1] 李昭骥[1] 

机构地区：[1]广州医学院第二附属医院中心ICU,广东广州510260

出　　处：《中国急救医学》2006年第6期409-411,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 研究危重病监护病房内粒细胞缺乏症患者的临床特征、抗生素经验性治疗、综合性治疗、影响预后的因素。方法 对我院危重病监护病房2000—06-2005—12收治的24例伴有粒细胞缺乏症的危重病惠者的临床资料做回顾性分析。结果 粒细胞缺乏症的原因主要为严重感染、化疗后和药物引起；所有患者均有感染，阴性杆菌占50％（17／34），阳性球菌和真菌分别占32．4％（11／34）和17．6％（6／34）；生存组与死亡组APACHEⅡ评分、首选抗生素应用有效率、治疗3d后粒细胞计数差异有统计学意义。结论 在伴有粒细胞缺乏症的危重病患者的感染中，阴性杆菌感染率最高，阳性球菌和真菌感染率亦有较高比例；首选抗生素应用有效率、治疗3d后粒细胞计数是影响预后的重要因素；对患者的生命器官进行支持治疗对于降低患者的死亡率有重要的作用。Objictives To study clinic feature, empiric antibiotic therapy and prognosis of neutropenia syndrome in patient with neutropenia syndrome intensive care unit.Methods A total of 24 cases with neutropenia syndrome in intensive care unit during Jun 2000 to Dec 2005 were studied retrospectively. Results The main pathogeny of neutropenia syndrome was serious infection, chemotherapeutics and drugs; All patients suffer from infection,the rate of Gram - negative was 50%, Gram- positive bacteria and fungi were 32.4% and 17.6%, respectively; The APACHE Ⅱ score,rate of satisfactory response of the empiric antibiotic therapy and the count neutrophil in three days after treatment in survival group was significantly different from death group. Conclusions In critical patients with neutropenia syndrome, the infectious rate of Gram- negative was the highest, Gram- positive bacteria and fungi was higher; the rate of satisfactory response of the empiric antibiotic therapy and the count neutrophil in three days after treatment may affect prognosis of patients, the support therapy of organ function play important role to drop mortality.

关 键 词：粒细胞缺乏症 经验性抗生素治疗 回顾性研究 

分 类 号：R557.3[医药卫生—血液循环系统疾病]