血液肿瘤患者化疗后肛周感染危险因素病例对照研究

Case-control Study on Risk Factors of Perianal Infection in Patients with Hematological Malignancy undergoing Chemotherapy

目的探讨血液肿瘤患者接受化疗后发生肛周感染的危险因素。方法采用回顾性病例对照研究的方法,对四川省某三级甲等医院血液内科2020年12月—2021年5月收治的进行化疗的348例血液肿瘤住院患者相关资料(人口学特征、疾病特征、医疗及护理病例记录、实验室检查结果)予以回顾性分析,根据出院诊断发生肛周感染的病例作为病例组,其余病例作为对照组,统计血液肿瘤患者接受化疗后肛周感染的发生率,采用单因素分析和二元Logistic回归分析肛周感染的危险因素。结果348例血液肿瘤化疗患者,发生肛周感染35例,感染率为10.1%;Logistic回归分析显示,年龄<60岁(OR=8.776,P=0.039)、痔疮史(OR=7.733,P<0.001)、肛周感染史(OR=14.981,P<0.001)、腹泻(OR=3.893,P=0.019)及白细胞计数<1×10^(9)/L(OR=6.851,P=0.002)是血液肿瘤患者接受化疗后发生肛周感染的独立危险因素。结论血液肿瘤患者接受化疗后肛周感染的发生率较高,年龄<60岁、痔疮史、肛周感染史、腹泻、白细胞计数<1×10^(9)/L导致血液肿瘤化疗患者肛周感染率增加,在护理化疗期的血液肿瘤患者过程中,应该结合肛周感染的危险因素,采取针对性干预措施,降低肛周感染发生率。

Objective To investigate the risk factors of perianal infection in patients after chemotherapy for hematologic malignancies.Methods A Retrospective case-control study was performed on relevant clinical data(demographic characteristics,disease characteristics,medical and nursing records,laboratory results)collected from of 348 patients with hematologic malignancies who were admitted to a tertiary grade-A hospital in Sichuan Province for chemotherapy from December 2020 to May 2021.According to discharge diagnosis,the patients with perianal infection were selected as the case group and the other patients as the control group.The incidence of perianal infection after chemotherapy in patients with hematologic malignancies was analyzed,and the risk factors of perianal infection were analyzed by univariate analysis and binary logistic regression.Results Among the 348 patients,perianal infection occurred in 35 cases with an infection rate of 10.1%.Logistic regression analysis indicated that younger than 60(OR=8.776,P=0.039),a history of hemorrhoids(OR=7.733,P<0.001),perianal infections(OR=14.981,P<0.001)or diarrhea(OR=3.893,P=0.019),and white blood cell count less than 1×10^(9)/L(OR=6.851,P=0.002)were independent risk factors for perianal infection in patients with hematologic malignancies treated with chemotherapy regimens.Conclusion Patients with hematological malignancies undergoing chemotherapy are threatened by an increased risk of perianal infection if aged<60,having a history of hemorrhoids,perianal infections,or diarrhea,or presenting with white blood cell count less than 1×10^(9)/L.Pertinent nursing strategies that appropriately incorporate these risk factors should be considered to prevent perianal infection in patients on chemotherapy for hematologic malignancies.