白血病患者行异基因外周血造血干细胞移植后发生感染的影响因素分析和预防  

Influencing Factors and Prevation of Infection in Leukemia Patients after Allogeneic Peripheral Blood Stem Cell Transplantation

作　　者：申亚琼[1] 付玥玥 李丽敏[1] 王艳[1] 孟令伶[1] 翟秋艳[1] SHEN Ya-Qiong;FU Yue-Yue;LI Li-Min;WANG Yan;MENG Ling-Ling;ZHAI Qiu-Yan(Department of Hematology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China)

机构地区：[1]哈尔滨医科大学附属第一医院血液内科,黑龙江哈尔滨150001

出　　处：《中国实验血液学杂志》2020年第4期1344-1348,共5页Journal of Experimental Hematology

基　　金：黑龙江省教育厅科学技术研究项目(12541448)。

摘　　要：目的:探讨异基因外周血造血干细胞移植后患者发生感染的影响因素以及应对措施。方法:选取2016年8月至2018年3月于本院血液科治疗的白血病患者共126例,调查移植后发生感染的患者例数,分析其感染原因,总结预防措施。结果:126例患者中,感染检测结果为阳性的患者共43例,感染率为34.13%。共检出89株病原体,其中细菌占64.05%;病毒占22.47%,真菌占13.48%。患者的年龄、供体类型、移植前感染、预防性使用抗生素以及aGVHD等因素均是患者感染的影响因素(P<0.05)。患者随访结果显示,采用预防方案干预后,干预组感染发生率明显下降(P<0.05)。经过合理护理干预后,干预组患者随访12个月的感染发生率低于对照组(P<0.05)。结论:移植前感染以及预防性使用抗菌药物是异基因造血干细胞移植感染的影响因素。可通过合理的感染预防手段降低其感染发生率。Objective:To explore the influencing factors and countermeasures of infection in leukemia patients after allogeneic peripheral blood hematopoietic stem cell transplantation.Methods:A total of 126 patients with leukemia admitted in our hospital from August 2016 to March 2018 were selected.The number of infected patients after transplantation was recorded,and the causes of infection were analyzed.Results:Among the 126 patients,43 were positive for infection,and the infection rate was 34.13%.A total of 89 pathogens were detected,of which bacteria accounted for 64.05%;virus accounted for 22.47%,and fungi accounted for 13.48%.The patient′s age,donor type,pretransplant infection,prophylactic use of antibiotics and aGVHD all were factors influencing the patient′s infection(P<0.05).The follow-up results showed that the incidence of infection in the intervention group significantly decreased after intervention with prevention program(P<0.05).After reasonable nursing intervention,the incidence of infection in the intervention group after follow-up for 12 months was lower than that in the control group(P<0.05).Conclusion:Pre-transplant infection and prophylactic use of antibiotics are factors influencing the infection after allogeneic hematopoietic stem cell transplantation.The incidence of infection can be reduced by reasonable infection prevention.

关 键 词：异基因造血干细胞移植 白血病 移植感染 

分 类 号：R733[医药卫生—肿瘤] R457[医药卫生—临床医学]