老年侵袭性非霍奇金淋巴瘤治疗后医院感染的临床分析

Nosocomial Infection among Senile Patients with Aggressive Non-Hogikin′s Lymphoma after Chemotherapy:A Clinical Analysis

目的研究老年侵袭性非霍奇金淋巴瘤医院感染的危险因素及病原学特点。方法 85例老年侵袭性非霍奇金淋巴瘤患者接受化疗508例次,观察医院感染例次率、病死率及感染部位,进行病原学检测,分析与治疗次数、化疗方案、分期、中性粒细胞及慢性系统性疾病的关系。结果老年侵袭性非霍奇金淋巴瘤医院感染例次率及病死率分别为34.1%和2.4%,非老年组为13.9%和0.8%,老年组较非老年组增高(P<0.01);下呼吸道及血液感染发生率老年组为23.1%和3.5%,高于非老年组的14.0%和1.0%(P<0.05);真菌感染检出率老年组为35.2%,高于非老年组的24.2%(P<0.05);治疗次数、分期、中性粒细胞<0.5×109/L及持续时间>10 d、慢性系统性疾病提高老年侵袭性非霍奇金淋巴瘤医院感染例次率及病死率(P<0.05)。结论年龄、多疗程、分期、中性粒细胞减少程度及持续时间、慢性系统性疾病与老年侵袭性非霍奇金淋巴瘤医院感染有关。

OBJECTIVE To study the risk factors and etiology of the nosocomial infection among senile patients with aggressive non-Hogikin′s lymphoma（aNHL） who received chemotherapy.METHODS Eighty-five cases of senile patients with aNHL received 508 times of chemotherapy with etiological examination,and were analyzed the relationship between nosocomial infection with the times and schemes of chemotherapy,stage of aNHL,absolute neutrophil count in peripheral blood,and chronic systemic disorders.RESULTS The nosocomial infection rate of senile patients with aNHL was 34.1%,and the mortality rate was 2.4% vs 13.9% and 0.8% in younger patients（P0.01）.The infection of senile patients in lower respiratory was 23.1% and in septicemia was 3.5%,vs 14.0% and 1.0% in younger patients（P0.05）.The positive rate of fungal infection of senile patients was 35.2% vs 24.2% in younger patients（P0.05）.Times of chemotherapy,stage,neutrophil count in peripheral blood lower than 500/ml and over 10 days after chemotherapy,and chronic systemic disorders increased the nosocomial infection rates and the mortality rate of senile patients with aNHL（P0.05）.CONCLUSION Age,times of chemotherapy,stage,the neutrocytopenia level with prolonged time,chronic systemic disorders are related to the nosocomial infection in senile patients with aNHL.