儿童急性白血病化疗后感染的临床分析

Clinical analysis of nosocomial infections in acute leukemia children after chemotherapy

目的了解儿童急性白血病化疗患儿医院感染特点,调查相关危险因素,为预防与控制医院感染提供科学的理论依据。方法回顾性调查急性白血病患儿住院化疗的临床资料。结果在住院的702例患儿中,发生医院感染有358例、704例次,感染率为51.00%、例次感染率为100.28%;呼吸道是最常见的感染部位,占46.02%,其次是消化道和血液,分别占31.11%、11.80%;医院感染的病原体中革兰阴性菌占41.96%,其次是革兰阳性菌与真菌,分别为占24.11%、18.75%,病毒占10.71%。结论急性白血病化疗后感染发生率高,化疗后积极加强支持治疗,提高机体抵抗力,及时发现感染灶,加强护理,合理使用抗菌药物,是降低医院感染的有效措施。

OBJECTIVE To study the clinical features of nosocomial infections and investigate the correlative risk factors for acute leukemia children after chemotherapy so as to provide theoretical basis for the prevention and control of nosocomial infections.METHODS The clinical data of hospitalized children with acute leukemia who underwent chemotherapy were retrospectively analyzed.RESULTS Among 702 cases with acute leukemia,there were 358 cases（704 case-times） of children with nosocomial infections with the infection rate of 51.00% and the case-time infection rate of 100.28%.The most common infection site was the respiratory tract（46.02%）,followed by the digestive tract（31.11%） and blood（11.80%）.Of the pathogens causing nosocomial infections,the gram-negative bacteria accounted for 41.96%,followed by the gram-positive bacteria（24.11%）,fungi（18.75%）,and virus（10.71%）.CONCLUSION The incidence of nosocomial infections in the children with acute leukemia is high after chemotherapy.There are many effective actions to reduce the nosocomial infections,such as strengthening supportive care,enhancing immunity,finding the infection foci in a timely manner,intensifying the nursing,and reasonably using antibiotics.