急性白血病继发败血症的临床研究

Nosocomial Septicemia for Acute Leukemia Patients: An Clinical Analysis

目的探讨急性白血病(AL)患者医院败血症的临床特点。方法分析310例住院治疗的AL患者临床资料。结果310例AL患者1812次住院中共发生医院败血症50例,粒细胞缺乏组医院败血症发生率、败血症死亡率明显高于非粒细胞缺乏组(P<005);败血症感染部位以口腔、肺部及肛门为主,致病菌主要是革兰阴性杆菌、革兰阳性球菌和真菌,致病菌平均耐药率高。结论粒细胞缺乏是AL合并医院败血症的高危因素及影响败血症预后的重要因素,应积极预防与处理;加强对肺部、口腔及肛门等易继发感染部位的护理与体查并及时处理感染灶;注意合理使用抗生素。

OBJECTIVE To clarify the features of nosocomial septicemia for acute leukemia(AL) patients. METHODS A total of 310 cases of AL treated in our hospital were analyzed retrospectively. RESULTS Among 310 patients with AL, 50 patients suffered from nosocomial septicemia. The incidence and the case mortality of septicemia in the granulocytopenia group were significantly higher than those in the non granulocytopenia one (P<0 05) . Most of the infections took place in the lung, mouth and anus and the major pathogens were Gram negative bacilli, Gram positive cocci and fungi. The rate of drug resistance was high. CONCLUSIONS AL patients with granulocytopenia should be given more active treatments and prophylaxes for it's a high risk factor and a poor prognostic factor complicating with septicemia; lung, mouth and anus should be nursed and inspected carefully and infection must be treated timely; antibiotics should be used rationally.