急性淋巴细胞白血病化疗患儿发生导管相关血流感染的影响因素  

Influencing factors of catheter-related bloodstream infection in children with acute lymphoblastic leukemia undergoing chemotherapy

作　　者：李金霞 董新园 LI Jinxia;DONG Xinyuan(Children’s Hospital Affiliated to Zhengzhou University,Henan Provincial Children’s Hospital,Department of Hematology and Oncology,Zhengzhou Children’s Hospital,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院血液肿瘤科,河南郑州450000

出　　处：《中国民康医学》2022年第9期15-17,21,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨急性淋巴细胞白血病(ALL)化疗患儿发生导管相关血流感染(CRBSI)的影响因素。方法:回顾性分析2017年1月至2020年12月该院收治的253例ALL化疗患儿的临床资料,根据化疗期间是否发生CRBSI分为发生组和未发生组,收集两组患儿一般临床资料和可疑影响因素,并对可能导致ALL化疗患儿发生CRBSI的影响因素进行单因素和多因素Logistic回归分析。结果:253例ALL化疗患儿中,24例发生CRBSI,发生率为9.49%;性别、年龄、住院季节与ALL化疗患儿发生CRBSI无明显相关性(P>0.05);发生组穿刺次数≥3次、白细胞计数<2×10^(9)/L、使用糖皮质药物、未预防性使用抗菌药物、中性粒细胞缺乏持续时间≥7 d、化疗次数≥3次、置管时间≥3 d占比高于未发生组,差异有统计学意义(P<0.05);Logistic回归分析显示,穿刺次数≥3次、白细胞计数<2×10^(9)/L、使用糖皮质药物、中性粒细胞缺乏持续时间≥7 d、化疗次数≥3次、置管时间≥3 d均为影响ALL化疗患儿发生CRBSI的危险因素,而预防性使用抗菌药物为保护因素(P<0.05)。结论:穿刺次数≥3次、白细胞计数<2×10^(9)/L、使用糖皮质药物、中性粒细胞缺乏持续时间≥7 d、化疗次数≥3次、置管时间≥3 d均为影响ALL化疗患儿发生CRBSI的危险因素,而预防性使用抗菌药物为保护因素。Objective:To explore influencing factors of catheter-related bloodstream infection(CRBSI)in children with acute lymphoblastic leukemia(ALL)undergoing chemotherapy.Methods:The clinical data of 253 children with ALL who received chemotherapy in our hospital from January 2017 to December 2020 were retrospectively analyzed.These patients were divided into occurrence group and non-occurrence group according to whether CRBSI occurred during the chemotherapy.The general clinical data and the suspicious influencing factors of the two groups of patients were collected.Univariate and multivariate Logistic regression analysis were performed on the influencing factors that may lead to the occurrence of CRBSI in the children with ALL undergoing chemotherapy.Results:Among the 253 children with ALL undergoing chemotherapy,24 cases developed CRBSI with an incidence rate of 9.49%.There were no significant correlations among gender,age,hospitalization season and the occurrence of CRBSI in the children with ALL undergoing chemotherapy(P>0.05).The proportions of number of punctures≥3 times,the total number of white blood cells<2×10^(9)/L,the use of glucocorticoids,no prophylactic use of antibiotics,the duration of neutropenia≥7 d,the number of chemotherapy≥3 times,and the catheterization time≥3 d of the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the number of punctures≥3 times,the total number of white blood cells<2×10^(9)/L,the use of glucocorticoids,the duration of neutropenia≥7 d,the number of chemotherapy≥3 times,and the catheterization time≥3 d were all the risk factors affecting the occurrence of CRBSI in the children with ALL undergoing chemotherapy,and the prophylactic use of antibiotics was the protective factor(P<0.05).Conclusions:The number of punctures≥3 times,the total number of white blood cells<2×10^(9)/L,the use of glucocorticoids,the duration of neutropenia≥7 d,the numbe

关 键 词：急性淋巴细胞白血病 化疗 患儿 导管相关血流感染 影响因素 

分 类 号：R733.71[医药卫生—肿瘤]