白血病患者血流感染危险因素分析  

Risk factors for bloodstream infections in leukemia patients

作　　者：周文锦[1,2] 俞康[3] 郑翠苹 柳文强 

机构地区：[1]温州医学院定理临床学院 [2]温州市中心医院血液化疗科,浙江温州325000 [3]温州医学院附属第一医院血液科,浙江温州325000 [4]浙江大学基础医学院免疫学系,浙江杭州310000

出　　处：《中华医院感染学杂志》2013年第22期5421-5422,5425,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金项目(2011KSR236)

摘　　要：目的探讨白血病患者血流感染危险因素,为制定相应的干预措施提供参考依据。方法选取2011年6月-2012年12月36例白血病血流感染患者,另选择36例未发生血流感染的白血病患者作为对照组,采用单因素χ2检验与多因素logistic回归分析对血流感染相关因素进行分析。结果住院时间>30d、不合理使用抗菌药物、血红蛋白<30g/L、动静脉插管、急性髓细胞白血病、白细胞数<4×109/L、使用皮质激素、肛周疾病等因素为白血病患者血流感染的相关因素;多因素logistic回归分析,共筛选出5个高危因素,包括住院时间>30d、动静脉插管、白细胞数<4×109/L、输血和肛周疾患。结论白血病患者血流感染危险因素较多,应做好患者住院期间临床护理,严格无菌操作,减少侵入性操作,做到安全输血,以预防白血病患者血流感染。OBJECTIVE To investigate the risk factors for bloodstream infections in the leukemia patients so as to put forward corresponding intervention measures. METHODS A total of 36 cases of leukemia patients with blood- stream infections , who were enrolled the hospital from Jun 2011 to Dec 2012 , were included in the study , mean- while , 36 cases of leukemia patients without bloodstream infections were assigned as the control group, then the univariate chi--square test and the multivariate logistic regression analysis were performed to analyze the related factors for the bloodstream infections. RESULTS The chi-square test for the exposed factors indicated that the length of hospitalization more than 30 days , unreasonable use of antibiotics , hemoglobin level less than 30 g/L, vascular catheterization , acute myeloid leukemia, leucocytes count less than 4×10^9/L, use of corticosteroids, and perianal diseases were the related factors for the bloodstream infections in the leukemia patients; the multivari- ate logistic regression analysis indicated that five high risk factors were screened out , including the length of hos- pitalization more than 30 days, vascular catheterization , leucocytes counts less than 4×10^9/L, blood transfu- sion, and perianal diseases . CONCLUSION There are many risk factors for the bloodstream infections in the leuke- mia patients, it is necessary to conduct good clinical nursing during the hospital stay , strictly carry out the aseptic operation, reduce the frequency of invasive operation, and ensure the safety of blood transfusion so as to prevent the bloodstream infections.

关 键 词：白血病 血液感染 危险因素 预防 

分 类 号：R733.7[医药卫生—肿瘤]