造血干细胞移植患者口腔溃疡和血流感染临床研究

Analysis of Clinical Features and Risk Factors for Oral Ulcers and Bloodstream Infection in Patients with Hematopoietic Stem Cell Transplantation

目的:探讨造血干细胞移植患者移植期间发生口腔溃疡与血流感染的临床特征及危险因素。方法:回顾性分析郑州大学第一附属医院于2020年1月至2021年12月收治的401例造血干细胞移植患者的临床资料,并统计分析患者口腔溃疡及血流感染的危险因素。结果:401例患者中口腔溃疡的发生率为61.3%(246/401),血流感染发生率为9.0%(36/401),36例患者共培养出40株病原菌,其中G^(-)菌26株(65%),G^(+)菌13株(32.5%),真菌1株(2.5%)。单因素分析结果显示,口腔卫生与血流感染的发生相关。多因素分析结果显示,年龄≥14岁、疾病诊断为白血病、异基因造血干细胞移植是患者发生口腔溃疡的危险因素。结论:造血干细胞移植患者口腔溃疡发生率较高,年龄≥14岁、疾病诊断为白血病、异基因造血干细胞移植是患者发生口腔溃疡的危险因素,口腔卫生与血流感染的发生相关。

Objective: To investigate the risk factors of oral ulcers and bloodstream infection in patients with hematopoietic stem cell transplantation. Methods: The clinical data of 401 hematopoietic stem cell transplant patients in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were retrospective analyzed, and the risk factors of oral ulcers and bloodstream infection statistical and analyzed. Results: Among the 401 patients, the incidence of oral ulcers was 61.3%(246/401), and the incidence of bloodstream infection was 9.0%(36/401). A total of 40 strains of pathogenic bacteria were isolated from 36 patients, including 26 strains of Gram negative strains(65%), 13 strains of Gram positive strains(32.5%), and 1 strain of fungi(2.5%). Single-factor analysis showed that oral hygiene was associated with the occurrence of bloodstream infection, and the Multi-factor analysis showed that age ≥14 years old, disease diagnosis of leukemia, and allogeneic hematopoietic stem cell transplantation were risk factors for oral ulcers. Conclusion: The incidence of oral ulcers in patients with hematopoietic stem cell transplantation is high. The age ≥14 years, disease diagnosis of leukemia, and allogeneic hematopoietic stem cell transplantation were risk factors for oral ulcers in patients, and oral hygiene was associated with the occurrence of bloodstream infection.