儿童急性白血病合并呼吸道感染的危险因素及预防性护理干预分析

Risk factors and preventive nursing intervention for acute leukemia complicated with respiratory tract infection in children

目的探讨儿童急性白血病合并呼吸道感染的危险因素,并针对其危险因素提出预防性护理干预措施。方法选取2015年1月至2018年1月间陕西中医药大学第二附属医院收治的150例儿童急性白血病患者作为研究对象,收集患者痰液进行病原菌培养,根据痰培养结果确定合并呼吸道感染患者,并将77例合并感染者纳入研究组,73例未合并感染者归对照组,对两组患者的呼吸道感染危险因素进行单因素分析和Logistic多因素回归分析。结果儿童急性白血病合并单因素分析的结果,白细胞异常、血红蛋白异常、血小板异常、低蛋白血症、住院天数过长和去甲氧柔红霉素及阿糖胞苷(IA化疗方案)方面,差异均有统计学意义(均P<0.05)。Logistic多因素回归分析的结果表明,血小板异常、贫血、低蛋白血症和IA化疗方案是儿童急性白血病合并呼吸道感染的危险因素。结论儿童急性白血病合并呼吸道感染的危险因素包括血小板异常、贫血、低蛋白血症和IA化疗方案,必须在临床治疗和护理实践中开展针对性预防性护理干预措施,以降低儿童急性白血病患者并发呼吸道感染的概率和严重程度。

Objective To investigate the risk factors for childhood acute leukemia complicated with respiratory infections and to propose preventive nursing interventions. Methods A total of 150 children with acute leukemia treated at The Second Hospical Affiliated to Shaanxi University of Traditional Chinese Medicine from January 2015 to January 2018 were selected as the study subjects. Their sputum was collect- ed and their pathogens were cultured. According to the results of sputum cultures, patients were calssified into acute leukemia group （the study group, 77 patients ） and acute leukemia complicated with respiratory tract infections group （the control group, 73 patients）. Univariate analysis and Logistic multivariate regres- sion analysis were conducted for the risk factors of respiratory infection in the two groups. Results Accord- ing to the results of univariate analysis, there was a statistically significant difference in leukocyte abnormali- ties, hemoglobin abnormalities, platelet abnormalities, hypoalbuminemia, length of hospital stay, and de- methoxydaunorubicin and cytarabine （IA） chemotherapy regimens between the two groups （all P 〈0.05 ）. Logistic multivariate regression analysis showed that platelet abnormalities, anemia, hypoproteinemia, and IA chemotherapy were risk factors for childhood acute leukemia complicated with respiratory infection （all P 〈 0. 05）. Conclusion The risk factors for childhood acute leukemia complicated with respiratory tract infection include platelet abnormality, anemia, hypoproteinemia and IA chemotherapy. It is necessary to carry out targeted preventive nursing interventions in clinical treatment and nursing practice to reduce the in- cidence and severity of acute leukemia complicated with respiratory infections in children.