急性淋巴细胞白血病合并水痘感染患儿临床治疗效果的影响因素及预后分析  

Factors associated with treatment results of childhood acute lymphoblastic leukemia combined with varicella infection and the analysis of prognosis

作　　者：张劲松[1] ZHANG Jinsong(Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院感染科,长沙410007

出　　处：《中国中西医结合儿科学》2018年第5期449-451,共3页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探讨可能影响急性淋巴细胞白血病合并水痘感染患儿临床治疗效果以及预后的因素,为相关患儿的治疗方案制定提供依据。方法选取2014年2月至2017年5月在湖南省儿童医院感染科收治的急性淋巴细胞白血病合并水痘患儿29例为研究对象,比较不同治疗结局患儿在性别、年龄、病程、出现首发症状到入院时间间隔、既往化疗情况与入院时白细胞数的差异。结果经过治疗29例患儿中8例死亡,其平均年龄为(6.38±1.41)岁,与痊愈患儿21例,平均年龄为(6.43±2.18)岁,差异无统计学意义(P>0.05)。死亡患儿平均病程为(27.00±6.82)个月,痊愈患儿平均病程为(21.76±5.99)个月,差异无统计学意义(P>0.05)。死亡患儿出现首发症状到入院时间平均为(60.50±42.65)h,高于痊愈患儿的(14.33±12.25)h,差异有统计学意义(P<0.05)。死亡患儿化疗期间出现反复感染率与入院时白细胞数也高于痊愈患儿,差异有统计学意义(P<0.05)。结论急性淋巴细胞白血病患儿合并水痘感染后治疗效果与预后情况主要的影响因素包括患儿从出现首发症状到入院接受治疗的时间间隔以及患儿入院时的白细胞计数情况,此外,对于那些化疗期间出现了反复感染的患儿,其治疗效果与预后往往不佳,提示了对于高危患儿及其父母实施针对性的行为干预的重要性。Objective To study the factors that may affect the clinical treatment effect and the prognosis in children with acute lymphoblatic leukemia combined with varicella infection,and to provide evidence for designing the treatment plan for these children.Methods A total of 29 children with acute lymphoblastic leukemia combined with varicella infection were selected as the research subjects,who received treatment in the Infection Department of Hunan Children's Hospital from Feb.2014 to May 2017.Compare the differences in the following items among children with different treatment outcomes:gender,age,course of disease,the interval between the onset of first symptom and admission to hospital,the chemotherapy history and the WBC count on admission.Results After treatment,8 of the 29 children died,and there average age was(6.38±1.41)years.The other 21 children were cured,with an average age of(6.43±2.18)years.There was no statistical difference in age between them(P>0.05).The average course of disease was(27.00±6.82)months in the dead cases,while it was(21.76±5.99)months in those cured,the difference being of no statistical significance(P>0.05).The interval between the onset of first symptom and the admission to hospital was(60.50±42.65)h in the dead children,which was significantly higher than that in the children cured[﹙14.33±12.25﹚h],and there was statistical difference(P<0.05).The incidence rate of repeated infection during chemotherapy and the WBC count on admission in the dead children were higher than those in the children cured,the difference being statistical(P<0.05).Conclusion The main factors that affect the clinical treatment results and the prognosis in children with acute lymphoblastic leukemia combined with varicella infection include the interval between the onset of first symptom and admission to hospital for treatment,and the WBC count on admission.Besides,the children with repeated infection during chemotherapy are likely to have poor treatment results and prognosis,which suggests that it is

关 键 词：急性淋巴细胞白血病 水痘-带状疱疹病毒 合并感染 预后分析 儿童 

分 类 号：R725.5[医药卫生—儿科]