百级层流病房预防恶性血液病患者化疗后感染的回顾性研究  

Retrospective study on the prevention of infection in patients with hematological malignancies after chemotherapy in a class 100laminar flow ward

作　　者：季美华[1] 臧敏[1] 陈进 马海佳[1] 高颖[1] 周文庭 

机构地区：[1]南通市第一人民医院,江苏南通226001

出　　处：《中国感染控制杂志》2018年第2期116-120,共5页Chinese Journal of Infection Control

摘　　要：目的探讨百级层流病房在预防恶性血液病化学治疗(化疗)后并发感染中的价值。方法回顾性调查2016年3月—2017年2月某院血液科病房收治接受化疗的恶性血液病患者,根据患者的意愿,入住百级层流病房接受化疗为试验组,在普通病房接受化疗为对照组。对两组的感染发病率、发热持续时间、抗菌药物使用时间、住院时间及感染指标进行比较分析。结果共收治接受化疗恶性血液病患者267例。试验组74例,对照组193例。治疗期间患者感染发病率试验组为47.3%,低于对照组的72.0%,差异有统计学意义(P<0.001)。两组患者感染部位均以呼吸道、消化道、泌尿道为主。两组患者共检出病原菌45株,试验组检出7株,对照组检出38株,检出病原菌为大肠埃希菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌、铜绿假单胞菌及酵母菌属。试验组发热持续时间、抗菌药物使用时间及住院时间低于对照组(均P<0.05);试验组感染病例血清降钙素原(PCT)和C反应蛋白(CRP)水平低于对照组(均P<0.01),且PCT、CRP恢复正常的时间短于对照组(均P<0.05)。结论恶性血液病患者在百级层流病房接受化疗可以减少感染发病率,缩短住院时间,减轻患者经济负担,值得临床进一步推广。ObjectiveTo explore the value of class 100 laminar flow ward in the prevention of infection in patients with hematological malignancies（HM） after chemotherapy. MethodsPatients with HM and received chemotherapy in the department of hematology in a hospital from March 2016 to February 2017 were surveyed retrospectively, according to patients’ wishes, those who were admitted to the class 100 laminar flow ward and received chemotherapy were as trial group, and those who were admitted to the common ward and received chemotherapy were as control group. The incidence of infection, duration of fever, antimicrobial use time, length of hospital stay, and index of infection were compared and analyzed between two groups. ResultsA total of 267 patients with HM received chemotherapy, 74 cases in trial group and 193 in control group. During the chemotherapy period, incidence of infection in trial group was lower than that of control group （47.3% vs 72.0%, P〈0.001）. Respiratory tract, digestive tract, and urinary tract were main infection sites in both groups. A total of 45 strains of pathogens were isolated from two groups of patients, 7 strains were isolated from trial group and 38 from control group. The isolated pathogens were Escherichia coli, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, and yeast. Duration of fever, antimicrobial use time, and length of hospital stay in trial group were all lower than control group（all P〈0.05）; serum procalcitonin （PCT） and Creactive protein （CRP） levels in trial group were both lower than control group（both P〈0.01）, the time for PCT and CRP to return to normal in trial group were both lower than control group（both P〈0.05）. ConclusionPatients with MH and receive chemotherapy in class 100 laminar flow ward can reduce the incidence of infection, shorten the length of stay, and reduce the economic burden, it is worthy of further clinical promotion.

关 键 词：层流病房 血液病 化学治疗 感染 

分 类 号：R733[医药卫生—肿瘤]