美罗培南治疗儿童急性白血病化疗期间合并院内感染的临床分析

Clinical analysis of Meropenem in the treatment of nosocomial infection in children with leukemia after chemotherapy

目的评价美罗培南治疗儿童急性白血病化疗期间中性粒细胞减少合并院内感染时的临床疗效及安全性。方法52例儿童急性白血病患者强化疗后骨髓抑制期合并院内感染,开始感染时即使用美罗培南28例,在其他广谱抗生素无效的情况下改用美罗培南24例,美罗培南用法每次20mg/kg,每8小时1次,评价治疗效果及不良反应。结果美罗培南在治疗儿童急性白血病中性粒细胞减少合并院内感染的有效率为82.7%(43/52),且副作用少。开始使用美罗培南组起效时间明显低于更换使用美罗培南组(P<0.05),且使用抗生素的时间在开始即使用美罗培南组明显少于更换使用美罗培南组(P<0.05)。两组的治疗效果差异无显著性。结论美罗培南治疗儿童急性白血病患者化疗后骨髓抑制期合并感染效果明显且较安全,可作为儿童急性白血病患者化疗后骨髓抑制期合并感染的首选药物之一。

Objective To assess the curative effect and safety of Meropenem on acute leukemia children with neu- tropenia and nosocomial infection during chemotherapy clinically. Methods A total of 52 children with acute leukemia suf- fered from nosocomial infection in the period of myelosuppression after strong chemotherapy regimen, among which 28 were given Meropenem at the beginning of infection and 24 were given Meropenem after other broad-spectrum antibiotic failed, with the same dose of 20 mg/kg once every 8 hours. Then clinical effect and side effects were observed. Results Meropen- em improved clinical manifestations in 43 patients （ 82.7% ） ,with few side effects. The effective time in the group of Mero- penem at the beginning of infection was obviously less than that of the group of changing Meropenem（ P 〈 0.05 ）. The time of using antibiotics in the group of Meropenem at the beginning of infection was obviously less than that of the group of changing Meropenem（ P 〈 0.05 ）. There was no obvious significancy for the curative effect between two groups. Conclu- sions Meropenem is safe and has notable effect in the treatment of nosocomial infection with myelosuppression after chem- otherapy in acute leukemia children, and it can be one of the first choice therapies in the treatment of nosocomial infection with myelosuppression after chemotherapy in acute leukemia children.