中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
5期
554-556
,共3页
白血病%医院感染%儿童
白血病%醫院感染%兒童
백혈병%의원감염%인동
Leukemia%Nosocomial infection%Children
目的 总结白血病儿童并发医院感染的相关因素及其感染特点.方法 回顾性分析220例急性白血病患儿中发生医院感染96例的临床资料,总结不同化疗阶段、不同住院时间的感染情况及感染部位和菌种情况.结果 (1)不同化疗阶段患儿感染率:患儿诱导和巩固阶段感染率较高,分别为85.7％ (24/28)和76.7％ (23/30).(2)住院时间与医院感染的关系:住院时间长的患儿,受到医院感染的比例增加,0～7d为8.6％ (3/35),15 ～30 d为62.7％ (42/67).(3)医院感染的发生部位:以呼吸道感染最多见(58.3％,56/96),然后依次是胃肠道、血液、皮肤以及其他部位[17.7％ (17/96)、13.5％(13/96)、8.3％ (8/96)、2.1％ (2/96)].(4)医院感染菌种分布:以大肠埃希菌[21.8％ (26/96)]、枸橼酸杆菌最多见[16.8％(20/96)],细菌检出率较低的是白色念球菌[2.5％(3/96)]、曲霉菌[1.7％(2/96)]以及酵母菌[0.8％(1/96)].结论 目前白血病儿童的生存率不断提高,但也极易发生医院感染,化疗诱导与巩固阶段感染率升高,在医院住院过程中应根据引起感染的相关因素及其特点有针对性地干预,以降低医院感染的发生率.
目的 總結白血病兒童併髮醫院感染的相關因素及其感染特點.方法 迴顧性分析220例急性白血病患兒中髮生醫院感染96例的臨床資料,總結不同化療階段、不同住院時間的感染情況及感染部位和菌種情況.結果 (1)不同化療階段患兒感染率:患兒誘導和鞏固階段感染率較高,分彆為85.7％ (24/28)和76.7％ (23/30).(2)住院時間與醫院感染的關繫:住院時間長的患兒,受到醫院感染的比例增加,0～7d為8.6％ (3/35),15 ～30 d為62.7％ (42/67).(3)醫院感染的髮生部位:以呼吸道感染最多見(58.3％,56/96),然後依次是胃腸道、血液、皮膚以及其他部位[17.7％ (17/96)、13.5％(13/96)、8.3％ (8/96)、2.1％ (2/96)].(4)醫院感染菌種分佈:以大腸埃希菌[21.8％ (26/96)]、枸櫞痠桿菌最多見[16.8％(20/96)],細菌檢齣率較低的是白色唸毬菌[2.5％(3/96)]、麯黴菌[1.7％(2/96)]以及酵母菌[0.8％(1/96)].結論 目前白血病兒童的生存率不斷提高,但也極易髮生醫院感染,化療誘導與鞏固階段感染率升高,在醫院住院過程中應根據引起感染的相關因素及其特點有針對性地榦預,以降低醫院感染的髮生率.
목적 총결백혈병인동병발의원감염적상관인소급기감염특점.방법 회고성분석220례급성백혈병환인중발생의원감염96례적림상자료,총결불동화료계단、불동주원시간적감염정황급감염부위화균충정황.결과 (1)불동화료계단환인감염솔:환인유도화공고계단감염솔교고,분별위85.7％ (24/28)화76.7％ (23/30).(2)주원시간여의원감염적관계:주원시간장적환인,수도의원감염적비례증가,0～7d위8.6％ (3/35),15 ～30 d위62.7％ (42/67).(3)의원감염적발생부위:이호흡도감염최다견(58.3％,56/96),연후의차시위장도、혈액、피부이급기타부위[17.7％ (17/96)、13.5％(13/96)、8.3％ (8/96)、2.1％ (2/96)].(4)의원감염균충분포:이대장애희균[21.8％ (26/96)]、구연산간균최다견[16.8％(20/96)],세균검출솔교저적시백색념구균[2.5％(3/96)]、곡매균[1.7％(2/96)]이급효모균[0.8％(1/96)].결론 목전백혈병인동적생존솔불단제고,단야겁역발생의원감염,화료유도여공고계단감염솔승고,재의원주원과정중응근거인기감염적상관인소급기특점유침대성지간예,이강저의원감염적발생솔.
Objective To explore the related factors of nosocomial infection in children with leukemia and its character.Methods Retrospective analyzed 96 leukemia children with nosocomial infection who were come from 220 patients with acute leukemia.The information of the infection rate at different chemotherapy stages,different hospitalization time,site of infection and strain condition were recorded.Results (1) The infection rate of leukemia children at induction and consohdation stage were 85.7％ (24/28) and 76.7％ (23/30) respectively.(2) The infection rate increased with the duration of hospitalization periods.The infection rate was 8.6％ (3/35) at 0-7 d hospitalization periods and 62.7％ (42/67) at 15-30 d hospitalization periods.(3) The infection was prone to occurring at respiratory tract (58.3％,56/96),followed by gastrointestinal tract (17.7％ (17/96)),blood (13.5％ (13/96)),skin (8.3％ (8/96)) and other parts (2.1％ (2/96)).(4) The most frequency stain listed as Escherichia coli(21.8％ (26/96)),and Citrobacter (16.8％ (20/96)).The lower detection rates of the bacteria listed as Candida albicans (2.5％ (3/96)),Aspergillus(1.7％ (2/96)) and yeast (0.8％ (1/96)).Condusion Even though the survival rates of leukemia children is increasing due to technology development,nosocomial infection frequently occur.The high infection rates occur at chemotherapy induction and consolidation phase.Therefore intervention should be taken based on nosocomial infection in children leukemia such improving the environment of ward,enhancing the immune ability of children in order to decrease the incidence of hospital infection.
