急性白血病患者发生院内感染的临床相关因素分析和防治对策

Clinical analysis of related factors and preventive measures of nosocomial infection in patients with acute leukemia

目的 探究急性白血病患者发生院内感染的相关危险因素及预防方法.方法 采用回顾性调查统计分析2010年3月至2013年10月太原市中心医院接受治疗的急性白血病患者459例的临床资料,采用Pearson单因素分析及logistic回归分析确定急性白血病患者发生院内感染的相关危险因素.结果 459例急性白血病患者出现院内感染62例,感染率为13.51％,感染117例次,例次感染率为25.49％.其中最多见的感染部位为肺部感染,其构成比为25.81％.采用Pearson单因素分析显示,患者出现感染与年龄、住院时间、中性粒细胞计数、血小板计数、血红蛋白量、化疗、预防性应用抗生素、使用糖皮质激素以及糖尿病有关（P＜0.05）.将以上相关因素带入logistic回归分析得出,急性白血病患者发生院内感染的危险因素包括预防性应用抗生素、使用糖皮质激素以及合并糖尿病（P＜0.05）,血小板计数和血红蛋白量是急性白血病患者发生院内感染的保护因素（P＜0.05）.结论 医护人员要加强无菌观念,严格执行无菌操作,加强营养支持,尽可能缩短急性白血病患者的住院时间,减少侵入性操作的机会,从而有效减少急性白血病患者合并院内感染的几率.

Objective To analyze the related factors and preventive measures of nosocomial infection in patients with acute leukemia.Methods Selected 459 patients with acute leukemia in central hospital of Taiyuan and analyzed the risk factors of nosocomial infection by single factor Pearsonanalysis and logistic regression.Results Sixty-two cases had nosocomial infection in the 459 cases of acute leukemia,and the infection rate was 13.51%,117 times of infection occurred and the times infection rate was 25.49%.The most common infection site was lung and the constituent ratio was 25.81%.Single factor Pearsonanalysis showed that infection was related with age,hospitalization time,neutrophil glucocorticoid and diabetes using cell count,platelet count,hemoglobin,chemotherapy,prophylactic antibiotics （P 〈 0.05）.Logistic regression analysis showed risk factors of nosocomial infections included the preventive use of antibiotics,glucocorticoid use and diabetes in patients with acute leukemia （P 〈 0.05）,while platelet count and hemoglobin （P 〈 0.05） were protective factors for nosocomial infection in patients with acute leukemia.Conclusions The medical staff need to strengthen the aseptic concept,strictly implementing aseptic operation,reducing the invasive operation opportunities,and thus effectively reduce the chances of patients with acute leukemia complicated with nosocomial infection.