新诊断儿童急性白血病诱导治疗阶段院内感染危险因素分析

Analysis of risk factors of nosocomial infection during induction therapy phase in children with newly diagnosed acute leukemia

目的探讨新诊断儿童急性白血病诱导治疗阶段院内感染的危险因素。方法回顾性分析2014年10月至2017年6月在河南省儿童医院就诊的150例新诊断儿童急性白血病患儿诱导治疗阶段的临床资料,采用Pearson单因素分析及Logistic回归分析确定急性白血病患儿诱导阶段发生院内感染的相关危险因素。结果急性淋巴细胞白血病、急性早幼粒细胞白血病、急性髓系白血病(非M3)患儿诱导阶段院内感染率比较差异有统计学意义(P<0.05)。病房出入人员<4人/d、住院时间<30d、手卫生依从性好为新诊断儿童白血病患儿院内感染的保护因素,而年龄<3岁、粒细胞缺乏时间>7d、经外周静脉穿刺中心静脉置管(PICC置管)为院内感染的易感因素。结论急性白血病患儿诱导阶段院内感染率高,应限制或减少人员出入,严格执行手卫生制度,并尽量缩短住院时间、粒细胞缺乏时间以减少院内感染发生。

Objective To investigate the risk factors of nosocomial infection in children with newly diagnosed acute leukemia during induction therapy phase.Methods The clinical data of 150 children with newly diagnosed acute leukemia in Henan Children's Hospital from October 2014 to June 2017 were retrospecivel analyzed.Pearson univariate analysis and Logistic regression analysis were used to determine the risk factors of nosocomial infection in induction stage of acute leukemia.Results The nosocomial infection rates at induction stage of acute lymphoblastic leukemia,acute promyelocytic leukemia and acute myeloid leukemia(non-M3)were significantly different(P<0.05).Less than 4 persons accessing to ward per day,hospital stay<30 days,good compliance of hand hygiene were protective factors against nosocomial infection during induction stage in children with newly diagnosed acute leukemia.However,age<3 years old,granulocyte deficiency time>7 days and PICC catheterization were the risk factors for nosocomial infection.Conclusions The nosocomial infection rate of children with acute leukemia in induction stage is high.It is necessary to restrict or reduce personnel access,strictly implement hand hygiene system,and shorten hospitalization time and granulocyte deficiency time as far as possible to reduce incidence of nosocomial infection.