老年急性白血病医院感染的临床特点及危险因素分析

Thelanalysis of Clinical Features and Risk Factors of Hospital Infection in Elderly Patients with Acute Leukemia

目的探讨老年急性白血病医院感染的临床特点及危险因素,为临床诊治提供依据。方法选取2010年2月-2012年2月医院接受诊断和治疗的老年急性白血病医院感染患者86例,回顾性分析老年急性白血病医院感染的临床特点及危险因素,采用SPSS17.0统计软件进行数据分析,多因素分析采用logistic回归模型。结果 86例老年患者共检出病原菌42株,检出率为48.84%,其中革兰阴性菌22株占52.38%、革兰阳性菌12株占28.57%、真菌8株占19.05%;病死率达51.16%,老年白血病患者的主要危险因素为中性粒细胞计数、化疗周期、入院季节、住院时间,其危险度分别为6.812、3.124、2.556、2.082。结论老年急性白血病患者医院感染主要发生于呼吸系统,病原菌主要是革兰阴性菌,其更容易受到真菌的感染,中性粒细胞计数、化疗周期、入院季节、住院时间等为其危险因素。

OBJECTIVE To analysis the clinical features and risk factors of hospital infection in elderly patients with acute leukemia and provide the basis for clinical diagnosis and treatment. METHODS 86 of elderly patients with acute leukemia and hospital infection were selected as the observation group while 86 younger patients with acute leukemia and hospital infection at the same time were selected as the control group. The clinical features and risk factors were retrospectively analyzed. RESULTS There were no differences between two groups on the sites of infection （P〉0. 05）. The fungal infection rate of the observation group was 19.05% and it was obviously higher than that of the control group （P〈0. 05）. The neutrophil count, chemotherapy cycle, admission season and hospital stay were the main risk factors of the elderly patients with acute leukemia and the risk degrees were 6. 812, 3. 124, 2.556, 2.082 respectively. CONCLUSION The hospital infection of the elder patients with acute leukemia mainly occurred in respiratory trelt the major pathogen wins Gram-negative bacteria. The elder patients with acute leukemia were easily infected by fungaf. The neutrophil count, chemotherapy cycle, admission season and hospital time were the risk factors of the elderly patients with acute leukemia.