2518例患者化疗后粒细胞缺乏及感染因素分析  

Granulocyte Deficiency and Infection Factor Analysis of 2518 Patients After Chemotherapy

作　　者：顾卫军[1] 胡海波[1] 朱伟[1] 葛晋源 张鲁勤[1] 

机构地区：[1]徐州市第一人民医院血液科,江苏徐州221002

出　　处：《黑龙江医药》2016年第3期431-434,共4页Heilongjiang Medicine journal

摘　　要：目的:分析2518例恶性肿瘤患者化疗后粒细胞缺乏发生率与院内感染的相关危险因素及病原菌特点。方法:对2518例恶性肿瘤患者化疗后粒细胞缺乏与院内感染的情况进行回顾性研究,分析化疗后粒细胞减少的发生率、院内感染部位、相关危险因素和感染病原菌的特点。结果:2518例恶性肿瘤患者化疗后发生粒细胞减少为436例,占17.3%;其中出现院内感染为182例,占41.74%。感染部位以呼吸道、不明部位和消化道为主。院内感染危险因素与患者ECOG评分及粒细胞缺乏持续时间呈正相关。院内感染的病原菌以革兰阴性菌为第一位,其主要是铜绿假单胞菌、肺炎克雷伯菌和大肠埃希氏菌;其次是为革兰阳性菌,以金黄色葡萄球菌为主。结论:患者化疗出现粒细胞缺乏后易继发院内感染,缩短粒细胞缺乏的时间及合理预防应用抗生素,可降低院内感染率。Objective： To analyze granulocyte lack of incidence and the related risk factors for nosocomial infection and the pathogen characteristics analysis 2518 cases of patients with malignant tumor after chemotherapy. Methods： 2518 cases of patients with tumor after chemotherapy granulocyte absence and hospital infection were retrospectively study, analysis the incidence of granulocytopenia after chemotherapy and nosocomial infection, the related risk factors and the characteristics of infectious pathogens. Results： 2518 cases of patients with malignant tumor after chemotherapy and 436 cases of granulocytopenia occurred, accounted for 17.3%; Nosocomial infection in 182 cases. The infection is given priority to with respiratory tract, unknown place and digestive tract. Patients with nosocomial infection risk factors and ECOG score and granulocyte lack duration were positively correlated. Pathogenic bacteria of nosocomial infection of gram-negative bacteria as the first, mainly is the pseudomonas aeruginosa, klebsiella pneumoniae and e.coli bacteria. Second is for gram positive bacteria, mainly staphylococcus aureus. Conclusion： Easily occurs after chemotherapy in patients with a granulocyte lack of nosocomial infection, shorten the time of the granulocyte lack and reasonable preventive use of antibiotics, can decrease the nosocomial infection rate.

关 键 词：粒细胞缺乏 化疗 院内感染 

分 类 号：R557[医药卫生—血液循环系统疾病] R730.5[医药卫生—内科学]