急性白血病患者骨髓增生程度与医院感染相关性研究

Correlation between the levels of bone marrow hyperplasia and nosocomial infections in patients with acute leukemia

目的探讨急性白血病(AL)患者骨髓增生程度与医院感染相关性,为医院感染的预防与控制提供科学依据。方法对2011-2013年医院血液病房的994例急性白血病患者进行前瞻性监测,填写急性白血病患者医院感染目标性监测登记表和医院感染病例调查表,采用SPSS19.0软件进行统计分析。结果 994例急性白血病患者发生医院感染277例、302例次,医院感染率27.87%、例次感染率30.38%;骨髓增生极度活跃的患者医院感染发生率最高为47.73%,其次为骨髓增生明显活跃患者,感染率为44.26%,骨髓增生不同程度患者医院感染率之间比较,差异有统计学意义(P<0.01);骨髓增生患者最常见的医院感染部位均为呼吸道;干燥奈瑟氏菌和酿脓链球菌为主要的病原菌。结论应密切关注患者骨髓像的变化,针对骨髓增生不同时期,采取针对性的治疗和护理措施,降低医院感染率。

OBJECTIVE To investigate the relationship between the bone marrow hyperplasia and nosocomial infections in patients with acute leukemia,and to provide scientific reference for prevention and control of nosocomial infections.METHODS A perspective monitoring was conducted on 994 acute leukemia patients treated in the homological ward from the year of 2011 to 2013.The registration form of target monitoring and the investigation form of nosocomial infection cases were recorded.The statistical analysis was made by software SPSS19.0.RESULTS The incidence of nosocomial infections in patients with acute leukemia was 277 cases and 302case-times with the nosocomial infection rate was 27.87%and the case-time infection rate was 30.38%.Patients with extremely active bone marrow hyperplasia had the highest infection rate of 47.73%,followed by significantly active patients,44.26%.The difference in nosocomial infection rate was significant among patients with different levels of bone marrow hyperplasia（P〈0.01）.The most common site of nosocomial infection was upper respiratory tract.Neisseria siccaand Streptococcus viridians were the main pathogenic bacteria.CONCLUSIONClinicians should pay close attention to the change of patients＇ bone marrow images and take targeted measures for patients in the different stages of bone marrow hyperplasia so as to reduce the rate of nosocomial infections.