恶性血液病患者粒细胞缺乏症并发感染的研究  

Study of agranulocytosis complicated with infection in patient with hematological malignancy

作　　者：张玲[1] 叶彦军 姚亚洲[1] ZHANG Ling;YE Yanjun;YAO Yazhou(Baoji Central Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市中心医院,陕西宝鸡721000

出　　处：《临床医学研究与实践》2018年第1期12-13,共2页Clinical Research and Practice

摘　　要：目的分析引起恶性血液病患者粒细胞缺乏症并发感染的相关因素,寻找合理的预防方式。方法选择我院收治的恶性血液病患者中发生粒细胞缺乏症并发感染者390例为研究对象,对感染原因进行分析。结果 1 606例病患中,发生粒细胞缺乏症者504例,总发生率为31.38%;其中急性白血病发生率最高(67.02%)。504例粒细胞缺乏症者中,院内感染390例,总感染率为77.38%。当白细胞数量在(0~0.5)×109/L时,患者的医院感染率明显高于其他组,粒细胞缺乏时间明显大于其他组(P<0.05);而平均感染持续时间与其他组比较,无显著差异(P>0.05)。本次研究最终取得菌株258株,其中真菌46株(17.83%),革兰阳性菌70株(27.13%),革兰阴性菌142株(55.04%)。化疗、激素免疫治疗、2型糖尿病、中性粒细胞数量少以及粒细胞缺少时间长均为造成粒细胞缺乏症并感染的危险因素。结论恶性血液病粒细胞缺乏症者中,接受化疗、激素治疗,合并2型糖病以及粒细胞缺乏时间较长者均为发生医院感染的高危群体,对于该部分人群,医生应当结合引致感染的危险因素,实施针对性应对措施,进而降低患者感染率以及病死率。Objective To analyze the related factors of agranulocytosis complicated with infection in patients with hematological malignancy,and find a reasonable way to prevent it.Methods A total of 390 hematological malignancy pa tients with agranulocytosis complicated with infection were selected as the research objects,and the causes of infection were analyzed.Results Among 1 606 patients,504 cases of patients occurred agranulocytosis,with a total incidence of 31.38%,the incidence of acute leukemia(67.02%)was the highest.Of the 504 cases of agranulocytosis,390 patients had nosocomial infections,with a total infection rate of 77.38%.When the number of white blood cells was between(0-0.5)×109/L,the nosocomial infection rate was significantly higher than that of other groups,and the time of agranulocytosis was significantly longer than that of other groups(P<0.05);but the average duration of infection was not significant different from other groups(P>0.05).In this study,258 strains were finally obtained,of which,46 strains(17.83%)were fungi,70 strains(27.13%)were gram-positive bacteria and 142 strains(55.04%)were gram-negative bacteria.Chemotherapy,hor mone immunotherapy,type 2 diabetes,small number of neutrophils,and a long absence of agranulocytosis were the risk factors for agranulocytosis.Conclusion In patients with malignant hematopathy complicated with neutrophils,those receiv ing chemotherapy,hormone therapy,type 2 diabetes mellitus and a long time of granulocytic deficiency are high-risk groups for nosocomial infections.For these patients,physicians should implement targeted countermeasures to reduce the patients'infection rate and mortality according to the risk infection factors.

关 键 词：恶性血液病 粒细胞缺乏症 化疗 医院感染 

分 类 号：R733[医药卫生—肿瘤] R557.3[医药卫生—临床医学]