多发性骨髓瘤患者医院感染原因分析与控制

Causes and control strategies of hospital infections in patients with multiple myeloma

目的探讨多发性骨髓瘤(MM)患者发生医院感染的相关因素,为临床预防多发性骨髓瘤医院感染提供客观依据。方法回顾性调查2011年6月-2012年12月收治的64例多发性骨髓瘤患者的临床资料,分析发生医院感染的原因,并总结应对策略。结果 64例多发性骨髓瘤患者中发生医院感染31例、46例次,医院感染率为48.4%、例次感染率为71.9%;前3位感染部位为呼吸道、口腔及胃肠道感染,分别占54.4%,17.4%,13.0%;骨髓瘤细胞≥30%、疾病Ⅲ期、有骨损害、住院时间>45d、白细胞减少以及采用化疗治疗的患者医院感染率分别为71.0%、61.2%、68.6%、64.3%、66.7%、67.6%,以上是发生医院感染的相关因素。结论多发性骨髓瘤患者发生医院感染的原因有体液免疫缺陷、住院时间较长、中性粒细胞减少、化疗治疗等,为预防医院感染,应提高患者的护理质量、加强其个人卫生管理、改善营养,并采用合理的保护性隔离措施。

OBJECTIVE To analyze the correlation factors of hospital infection of multiple myeloma （MM） patients, in order to provide an objective basis for clinical prevention of infections. METHODS Clinical data of 64 cases of multiple myeloma patients from Jun 2011 to Dec 2012 in our hospital were selected and retrospective analyzed to find the causes of nosocomial infections and summarize the control strategies. RESULTS Totally nosocomial infections occurred in 31 cases, 46 case time among 64 cases of patients with multiple myeloma, and the hospital infection rate was 48. 4~//oo. The top three sites of infection were respiratory, oral and gastrointestinal infections, accounting for 54.4%, 17.40/00, 13.0%, respectively. The infection rates of patients with myeloma cells 30%, disease stage III, bone injury, stay time more than 45 day, neutropenia, chemotherapy were 71.0%, 61.2%, 68.6%, 64.3%, 66.7%, 67.6% respectively, and these factors were correlation factors of hospital infections. CONCLUSION The causes of hospital infections in patients with multiple myeloma （MM） include humorat immunodeficiency, longer hospital stay, neutropenia, radiation therapy, and so on. To prevent nosocomial infections, the quality of patient care should be improved, and the management of personal hygiene should be strengthened, and reasonable protective isolation measures should be taken.