急性淋巴细胞白血病患儿侵袭性真菌感染的临床分析

Clinical analysis of invasive fungus infections in children with acute lymphoblastic leukemia

目的:了解本院急性淋巴细胞白血病患者化疗后出现侵袭性真菌感染的发病率及高危因素,探讨有效的预防措施。方法:对本院2007年1月～2010年12月期间新确诊并化疗的急性淋巴细胞白血病患者187例进行了回顾性调查分析。结果:187例急性淋巴细胞白血病患儿共发生真菌感染38例次,真菌感染率为20.32%,侵袭性真菌感染17例次,感染率为9.09%,占真菌感染的44.73%。真菌感染部位主要为口腔,侵袭性真菌感染主要为肺部,发生真菌感染的危险因素有住院时间、中性粒细胞缺乏持续时间、长期使用抗生素等。结论:急性淋巴细胞白血病化疗期间,缩短住院时间,合理使用抗生素,在粒细胞持续降低期间,应用粒细胞集落刺激因子,预防性应用抗真菌药物,可有效降低侵袭性真菌感染。

Objective： To investigate the incidence and high risk factors of invasive fungus infections in children with acute lymphoblastic leukemia（ALL） who had received chemotherapy in our hospital,and try to find the effective measure of prevention fungus infections.Methods： We reviewed all children（187 patients） with ALL who received chemotherapy from January 2007 to December 2010.Results： 38 fungus infections occurred in 187 children with ALL,fungus infections rate was 20.32%,17 cases was occurred invasive fungus infections,the infections rate was 9.09%.The primary fungus infections location was oral cavity,the primary invasive fungus infections location was lung.The high risk factors of fungus infections include： length of in hospital,length of agranulocytosis,long term antibiotics therapy ect..Conclusion： Shortening the term of in hospital,adequate antibiotics therapy,using granulocyte colony-stimulating factor if agranulocytosis can depress the opportunity of invasive fungus infections when the patients received chemotherapy.