急性白血病患者化疗后继发感染性休克的临床研究  

Septic Shock for Acute Leukemia Patients:A Clinical Analysis

作　　者：周振海[1] 李小银[1] 李娟[1] 罗绍凯[1] 

机构地区：[1]中山大学附属第一医院血液内科,广东广州510080

出　　处：《中华医院感染学杂志》2010年第24期3907-3909,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨急性白血病(AL)患者化疗后继发感染性休克的临床特点、病原菌分布及耐药性,为临床防治提供参考。方法分析1210例住院治疗的AL患者继发感染性休克的临床资料。结果 1210例AL患者5763次住院化疗后共发生感染性休克45例,均为应用强化疗方案后,其中30例(66.7%)发生于复发难治再次诱导缓解治疗,死亡18例(40.0%),其中复发难治再次诱导治疗15例(83.3%);检出病原菌主要是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌等革兰阴性杆菌,耐药率高;通过抗休克、抗感染治疗,AL得到完全或部分缓解患者感染性休克可以得到有效控制。结论感染性休克多出现在复发难治AL再次诱导缓解化疗、强化疗方案治疗后,对此类患者要高度警惕继发感染性休克;及时积极有效的抗感染、抗休克治疗是控制感染性休克的关键。OBJECTIVE To explore the features,pathogen distribution and drug resistance of septic shock in acute leukemia（AL） patients.METHODS A total of 1210 cases of AL treated in our hospital were analyzed retrospectively.RESULTS Among 1210 patients with AL,45 patients suffered from septic shock.The incidence and the case mortality of septic shock were more common in the relapse and refractory AL patients with strong chemotherapy.The major infective microorganisms were Gram-negative Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae.The rate of drug resistance was high.After chemotherapy,those patients with complete or part remission would recover from septic shock through effective anti-shock and antibiotics treatment.CONCLUSION AL patients with granulocytopenia should be given more attention to prevent from septic shock,especially to the relapse and refractory AL patients with strong chemotherapy.The control of AL,effective anti-shock and antibiotics treatment are very important factors in the prognosis of AL patients with septic shock.

关 键 词：急性白血病 感染性休克 化疗 

分 类 号：R552[医药卫生—血液循环系统疾病]