中性粒细胞缺乏伴发热的肿瘤患者治疗方案分析

Treatment and therapeutic plan of febrile neutropenia in tumor patients

目的:探讨肿瘤化疗后发生的中性粒细胞缺乏伴发热症状的对症和对因治疗,对治疗方案综合分析。方法:回顾性收集某肿瘤专科医院2018年11月—2019年10月出现的50例中性粒细胞缺乏伴发热的肿瘤患者的临床资料,如性别、年龄、病种、体温、血常规、化疗方案及方案中涉及的化疗药物、是否入住层流病房、使用的升白药物及使用天数、使用的抗菌药物品种、是否联合使用抗菌药物等。结果:男性21例,女性29例,年龄18~70岁,平均年龄55.61岁;血液恶性肿瘤37例,实体瘤13例。患者经过一系列治疗(如升白治疗、抗感染治疗)后,除4例死亡外,其他46例体温及中性粒细胞绝对值恢复正常水平。结论:恶性肿瘤经过大剂量化疗,容易发生中性粒细胞缺乏伴发热,一旦发生,应予以积极的升白及抗感染治疗,使患者安全度过粒细胞缺乏期。

Objective:To investigate the symptoms and causes of neutropenia with fever in tumor patients after chemotherapy,and to analyze the treatment plan.Methods:Retrospectively collected a totle of 50 malignant tumor patients,clinical data associated with neutropenia and fever in a cancer hospital during November 2018 to October 2019,such as gender,age,diagnosis,body temperature,blood routine,chemotherapy regimens and involved in the scheme of chemotherapy drugs,whether to stay in laminar flow ward,whether use Recombinant Human Granulocyte Stimulating Factor Injection and use the number of days,the use of antibacterial drug varieties,such as whether joint use of antimicrobial agents.Results:Among the 50 patients,21 were males and 29 were females,aged 18-70 years,with an average age of 55.61 years.Hematologic malignancies accounted for 37 cases,solid tumors accounted for 13 cases.After a series of treatments(such as use Recombinant Human Granulocyte Stimulating Factor Injection treatment and anti-infection treatment),the temperature and absolute value of neutrophils returned to normal in the other 46 patients,except 4 patients died.Conclusion:Patients with malignant tumor are prone to develop neutropenia with fever after high-dose chemotherapy.Once it occurs,Recombinant Human Granulocyte Stimulating Factor Injection and anti-infection treatment should be given to make the patients pass through the neutropenia stage safely.