高强度化疗时代下儿童急性髓系白血病感染的临床研究

Infection in Children with Acute Myeloid Leukemia in the Intensive Chemotherapy Period

目的:研究儿童急性髓系白血病(AML)患儿在高强度化疗后感染的临床特点并探索防控措施。方法:选取2016年1月-2019年8月本院初诊AML患儿56例,分析总结其在诱导、巩固期感染的发生率、病原菌及感染部位。结果:AML患儿各阶段感染率在93.4%-96.4%之间,严重感染率平均值为16.0%(11.3%-19.6%),发生感染相关的死亡为10.7%。不明原因性发热是感染主要原因,而血流感染则常见于严重感染,以革兰氏阴性菌感染为主。化疗期间真菌感染率为35.7%。结论:儿童AML各化疗阶段均出现高感染发生率,重视血流感染导致的严重感染,预防性使用抗真菌药物以减少AML合并的真菌感染。

Objective:To investigate the clinical characteristics of infection in children with acute myeloid leukemia(AML)after high intensive chemotherapy,so as to provide reference for prevention and control of infection.Methods:56 children diagnosed as acute myeloid leukemia in our hospital from January 2016 to August 2019 were enrolled and retrospectively analyzed,the infection rate,pathogens of disease and common location of infection during the induction and consolidation period were analyzed.Results:The total infection rate of the patients was 93.4%-96.4%,the average of serious infection rate was 16.0%(11.3%-19.6%),and the infection related mortality was 10.7%.Fever of unknown cause was the main reason of infection,while blood flow infections were the most common in severe infection,which were mainly caused by Gram-egative bacteria.The rate of fungal infection was 35.7%during chemotherapy.Conclusion:Children with AML shows a high incidence of infection in each stage of chemotherapy.The serious illness caused by blood flow infection and take antifungal drugs to reduce the occurrence of fungal infection in AML patients should be paid attention.