化疗所致粒细胞缺乏症患者的院内感染

Chemotherappy Induced Agranulocytosis and Hospital Infection

目的 研究化疗所致粒细胞缺乏症患者的院内感染的发生及粒细胞集落刺激因子和抗生素对院内感染的预防作用。方法 按照外周血白细胞水平 ,将 196例患者分成 4组 :( 0～ 0 .499)× 10 9/L、( 0 .5～ 0 .999)× 10 9/L、( 1.0～ 1.499)× 10 9/L组和( 1.5～ 1.999)× 10 9/L组 ,调查各组院内感染发生率。所有患者均给予人重组粒细胞集落刺激因子 (G CSF)治疗 ,计算各组患者外周血白细胞升至正常值时所需的G CSF总量和时间。将本组患者分成预防性使用抗生素组和未预防性使用抗生素组 ,计算 2组患者实际感染发生率。结果 4组患者院内感染的发生率分别为 6 4.7%、5 4.7%、2 3.3%和 2 8.8% ,有非常显著性差异 (P <0 .0 1) ;各组患者使用G CSF的量分别为 ( 1889.71± 15 5 0 .39) μg、( 10 37.74± 72 4.2 1) μg、( 82 4.42± 6 2 5 .0 8) μg和 ( 6 2 1.97±5 88.36 ) μg ,有非常显著性差异 (P <0 .0 1)。恢复时间分别为 ( 6 .82± 4.0 7)天、( 5 .92± 4.0 7)天、( 5 .81± 3.6 1)天和 ( 6 .18± 4.31)天 ,无显著性差异 (P >0 .0 5 )。预防性使用抗生素组和未预防性使用抗生素组实际院内感染发生率分别为 36 .0 %和 43.8% ,无显著性差异 (P >0 .0 5 )。结论 化疗所致粒细胞缺乏症患者 。

Objective To study the relation between agranulocytosis induced by chemotherapy and hospital infection and to evaluate the preventive effect of granulocyte colony-stimulating factor and antibiotic on hospital infection.Methods A total of 196 patients with agranulocytosis were analyzed retrospectively.These patients were divided into four groups according to WBC count in peripheral blood:(0～0.499)×10~9/L,(0.5～0.999)×10~9/L,(1.0～1.499)×10~9/L and(1.5～1.999)×10~9/L.Hospital infection rate was invesgated in the groups.Results In patients enrolled in this study,the overall infection rate was 40.8%(80/196) and the infection rate of the four groups was 64.7%,54.7%,23.3% and 28.8% respectively,there was significantly difference(P<0.01).The study also showed that the amount of the needed CSF to restore WBC was significantly different(P<0.01),but the needed time didn′t show difference(P>0.05).There was no significant difference in hospital infection between antibiotic prevention group and control group(36.0% vs 43.8%,P>0.05).Conclusion Hospital infection rate is correlated with the degree of agranulocytosis in chemotherapy patients;Granulocyte colony-stimulating factor can effectively decrease hospital infection,instead of antibiotic.