异基因造血干细胞移植并发肛周感染的危险因素分析  

Risk factors analysis of perianal infection following allogeneic hematopoietic stem cell transplantation

作　　者：姚昱名 王明明[1] 施香君 邢晓慧 雷店 任抒文 Yao Yuming;Wang Mingming;Shi Xiangjun;Xing Xiaohui;Lei Dian;Ren Shuwen(Department of Nursing,People′s Hospital Affiliated to Jiangsu University,Zhenjiang 221000,China)

机构地区：[1]江苏大学附属人民医院护理部,江苏镇江221000 [2]江苏省军区徐州第四离职干部休养所 [3]河北燕达陆道培医院骨髓移植中心

出　　处：《护理学杂志》2024年第16期90-93,共4页Journal of Nursing Science

基　　金：国家自然科学基金青年项目(81900177)。

摘　　要：目的分析异基因造血干细胞移植并发肛周感染的危险因素,为临床制定肛周感染的防治方案提供参考。方法选取264例骨髓移植患者,按照移植后是否发生肛周感染分为肛周感染组和非感染组,采用logistic回归分析移植并发肛周感染的影响因素。结果264例患者中,肛周感染组51例(19.32%)。回归分析显示,既往有糖尿病史、肛周疾患史、二次移植、中性粒细胞植入时间为移植后并发肛周感染的危险因素,坐浴后规律使用保护剂为保护因素(均P<0.05)。结论异基因造血干细胞移植并发肛周感染的发生率较高,护理人员应重视既往病史、并存疾病的影响,重点针对二次移植的患者,尤其是在中性粒细胞未成功植入期间,加强肛周感染知识的健康宣教,做好肛周感染防护,减少移植并发肛周感染的发生率。Objective To analyze the risk factors for perianal infection following allogeneic hematopoietic stem cell transplantation(HSCT),and to provide a reference for the development of preventive and therapeutic strategies for perianal infections in clinical settings.Methods A total of 264 patients receiving bone marrow transplantation were selected and divided into an infection group and a non-infected group based on whether they developed perianal infections post-transplantation.Logistic regression analysis was used to explore the influencing factors of perianal infection following transplantation.Results The incidence of perianal infection after allogeneic HSCT was 19.32%(51/264).Logistic regression analysis showed that previous history of diabetes,history of perianal disease before transplantation,undergoing a second transplantation,and the time to neutrophil engraftment were risk factors for post-transplantation perianal infection,while regular use of protectants after sitz baths was identified as a protective factor(all P<0.05).Conclusion The incidence of perianal infection following allogeneic HSCT is high.Healthcare providers should consider patient′s medical history and comorbidities in their clinical assessments,especially focusing on patients undergoing a second transplantation.Particular emphasis should be placed on enhancing health education about perianal infection during the period of delayed neutrophil engraftment,and improving perianal infection protection measures,in a bid to reduce the incidence of perianal infection post-transplantation.

关 键 词：血液病 造血干细胞移植 肛周感染 肛周护理 危险因素 糖尿病 二次移植 感染防护 

分 类 号：R473.5[医药卫生—护理学]