造血干细胞移植层流室内一次性鼻导管吸氧管更换时间对患者移植相关指标的影响

Effect on patients' transplant related indexes by replacement time of disposable oxygen inhalation tube in laminar flow chamber of hematopoietic stem cell transplantation

目的通过对造血干细胞移植(HSCT)层流室内吸氧患者一次性鼻导管吸氧管的连续培养监测,评估管端培养阳性率、管端细菌感染对移植患者预后的影响。方法对2014年1月-2015年6月于北京大学血液病研究所行HSCT的73例患者给予鼻导管吸氧,并对一次性鼻导管吸氧管进行每日管端培养,以此分为培养阳性组及阴性组,阳性组进一步按培养阳性率发生时间进行分析。分析两组一次性鼻导管吸氧管更换时间对HSCT患者移植100d内肺部感染率、移植后急性移植物抗宿主病(aGVHD)、移植后100d死亡率的影响。结果 HSCT层流室内一次性吸氧管培养的人均阳性率为12.33%,例次阳性率为4.89%(25/511)。培养细菌种类上,阳性组9/10例为凝固酶阴性的葡萄球菌,1/10例为鞘氨醇单胞菌,均为条件致病菌。两组患者100d内肺部感染率、移植后aGVHD率、移植后100d死亡率差异均无统计学意义。结论造血干细胞移植层流室内可以每周更换一次性吸氧管,从而达到更好地优化造血干细胞移植的治疗-效价比。

Objective To evaluate the prognosis of patients undergoing hematopoietic stem cell transplantation(HSCT)by monitoring the continuous culture of disposable nasal catheter oxygen inhalation tubes in laminar flow chamber.Methods 73 patients underwent HSCT in institute of hematology of Peking University from January 2014 to June 2015 were given nasal catheter oxygen inhalation.The disposable nasal catheter oxygen inhalation tube was cultured daily at the end of the tube,which was divided into positive group and negative group.The positive group was further analyzed according to the time of occurrence of positive culture rate.The effects on replacement time of disposable oxygen inhalation tube,pulmonary infection rate,acute graft-versus-host disease(aGVHD)and 100-day mortality of HSCT patients within 100 days after transplantation was analyzed for the two group.Results The average positive rate of the disposable oxygen inhalation tube in the HSCT laminar flow room was 12.33%,the case-positive rate was 4.89%(25/511).The positive group included 9 coagulase negative staphylococci out of 10 cases,while 1/10 case was Sphingomonas,which were all opportunistic pathogens.There were no significant differences in lung infection rates,aGVHD rates and 100 days’mortality after transplantation between the two groups.Conclusion Replacement disposable oxygen inhalation tube every week is feasible and can optimize cost effectiveness of HSCT therapy.