成人急性白血病患者医院感染危险因素分析

The Risk Factors of Nosocomial Infection in Adults with Acute Leukemia

目的探讨引起成人急性白血病患者医院感染的危险因素,为医院感染预防措施的制定提供客观依据。方法对某三级甲等医院血液科2005年7月—2007年7月住院治疗的653例急性白血病病例进行回顾性调查研究,填写统一的个案登记表。其中386例为医院感染组,267例无任何感染者为非医院感染组,对两组资料进行单因素!2检验和多因素的非条件Logistic回归分析。结果医院感染的发生率为59.1%,多因素分析得出差异有统计学意义的危险因素有5项,分别为:预防性使用抗生素、使用糖皮质激素、肛周疾患、血红蛋白量、血小板计数。结论成人急性白血病患者医院感染率高。预防性使用抗生素、使用糖皮质激素和肛周疾患是成人急性白血病患者发生医院感染的独立危险因素,血红蛋白量及血小板计数是医院感染的保护因素。

Objective To study the risk factors of nosoeomial infection in adults with acute leukemia so as to provide a basis for hospitals to formulate preventive measures against nosoeomial infection. Methods A retrospective review of the medical records of 653 adult patients with acute leukemia hospitalized in the hematology department of a Grade 3A hospital between July 2005 and July 2007 were conducted. 386 eases were recorded as nosoeomial infection （NI） group and the other 267 without any infection as non-NI group. The data were analyzed with the single factor X2 test and muhifaetor logistic regression analysis. Results The incidence of nosoeomial infection was 59.1%（386/653）. The risk factors showing significant differences between the two groups included prophylac- tic application of antibiotics, corticosteroids therapy, perianal diseases, hemoglobin and platelet count. Conclusion The nosocomial infection rate in adults with acute leukemia is high. Prophylactic application of antibiotics, eortieosteroids therapy and perianal diseases are independent risk factors for nosoeomial infection in adult patients with acute leukemia. Hemoglobin concentration and platelet count are protective factors.