急性白血病感染败血症的危险因素分析及耐药性研究  

Risk Factors and Clinical Resistance of Secondary Septicemia in Patients with Acute Leukemia

作　　者：吴圣豪 郑翠苹 徐杰 

机构地区：[1]温州市中心医院,浙江325000

出　　处：《环境与职业医学》2013年第5期377-379,共3页Journal of Environmental and Occupational Medicine

摘　　要：[目的]探讨影响急性白血病(AL)感染败血症的危险因素,并对产生的病原菌进行药敏研究,为治疗继发败血症提供临床依据。[方法]对温州市中心医院2004年12月—2010年1月73例继发败血症的急性白血病患者临床资料进行回顾研究,将9种可能引起败血症的危险因素进行统计分析,再建立logistic回归模型;将病原菌分离后进行药敏实验,观察细菌分布及耐药情况。[结果]从9种可能的危险因素中筛选出5种主要的危险因素,分别为使用抗生素、年龄、住院时间、手术时间及白细胞计数;利用纸片扩散法(K-B法)检测细菌耐药情况,发现该院白血病继发败血症的细菌耐药情况十分严重。[结论]使用抗生素、年龄、住院时间、手术时间和白细胞计数是急性白血病继发败血症的独立危险因素,需要加强管理,尤其是对抗生素要加强使用规范,倡导合理用药。[ Objective ] To explore the risk factors of secondary septicemia in patients with acute leukemia （AL）, followed by drug susceptibility test of related pathogens, and to provide clinical evidences for future treatment of secondary septicemia. [ Methods ] From December 2004 to January 2010, the medical records of 73 AL cases with secondary septicemia were retrospectively reviewed. X2 test and logistic regression models were performed to analyze 9 potential risk factors of septicemia. Drug susceptibility test was applied to isolated pathogens using disc diffusion method to examine bacterial distribution and anti-microbial resistance. [ Results ] Totally 5 risk factors of septicemia in AL patients were identified, i.e. use of antibiotics, age, duration of hospitalization, duration of operation, and white blood cell count. The results of K-B assay indicated significant drug resistance in reviewed secondary septicemia. [ Conclusion ] The use of antibiotics, age, length of hospital stay, duration of operation, and white blood cell count are the independent risk factors of secondary septicemia in patients with acute leukemia and therefore need strengthened management, especially on rational use of drugs.

关 键 词：急性白血病 危险因素 药敏实验 

分 类 号：R733.71[医药卫生—肿瘤]