血液恶性肿瘤患者化疗后口腔感染的危险因素分析

Risk factors for oral infections in hematological malignancies patients after chemotherapy

目的探讨血液恶性肿瘤患者化疗后并发口腔感染的危险因素及防治对策,为临床预防口腔感染提供参考。方法选取2011年2月-2013年10月收治的224例血液恶性肿瘤接受化疗患者为研究对象,给予前瞻性研究,对化疗后发生口腔感染的可能危险因素进行单因素χ2检验以及多因素非条件logistic回归分析。结果224例化疗患者中有42例发生口腔感染,感染率18.8%,口腔感染的主要部位为颊部、牙龈,分别占38.1%、23.8%;经多因素logistic回归分析最终筛选出年龄、血清白蛋白水平<40g/L、粒细胞绝对值<0.5×109/L、口腔环境与口腔自洁习惯差、多次化疗周期、化疗未缓解是血液恶性肿瘤患者化疗后并发口腔感染的高危因素。结论血液恶性肿瘤患者因多种因素导致化疗后口腔感染的发生,应当积极的加强感染控制措施,对各种危险因素进行积极干预以降低口腔感染率。

OBJECTIVE To explore the risk factors for oral infections in hematological malignancies patients after chemotherapy and put forward the prevention countermeasures so as to provide guidance for clinical prevention of oral infections.METHODS A total of 224 patients with hematological malignancies who received the chemotherapy from Feb 2011 to Oct 2013 were recruited as the study objects,the prospective study was conducted;the univari-ate chi-square test and non-conditional multivariate logistic regression analysis were performed for the risk factors for the oral infections after the chemotherapy.RESULTS The oral infections occurred in 42 of 224 patients under-going the chemotherapy with the infection rate of 18.8%,among whom the patients with buccal infections accoun-ted for 38.1%,the patients with gingival infections 23.8%.The multivariate logistic regression analysis indicated that the age,level of serum albumin less than 40 g/L,absolute value of granulocytes less than 0.5＆#215;10^9/L,poor oral environment,bad oral self-cleaning habits,multiple cycles of chemotherapy,and no alleviation after chemo-therapy were the high risk factors for the oral infections in the hematological malignancies patients after the chemo-therapy.CONCLUSION There are a variety of risk factors for the oral infections in the hematological malignancies patients after the chemotherapy.It is necessary to strengthen the infection control measures and take active inter-ventions to the risk factors so as to reduce the incidence of oral infections.