实用医药杂志
實用醫藥雜誌
실용의약잡지
Practical Journal of Medicine & Pharmacy
2014年
7期
584-586
,共3页
白血病%粒细胞缺乏%医院感染%药物治疗%降阶梯治疗
白血病%粒細胞缺乏%醫院感染%藥物治療%降階梯治療
백혈병%립세포결핍%의원감염%약물치료%강계제치료
Leukemia%Agranulocytosis%Hospital infection%Medication%De-escalation therapy
目的：分析总结急性白血病患者化疗后粒细胞缺乏伴医院感染的临床特点，便于指导临床用药。方法回顾总结48例急性白血病住院患者化疗后并发感染，采用“降阶梯治疗”的策略，合理应用抗菌药物等治疗的相关临床资料。结果48例急性白血病患者化疗后发生医院感染36例，感染率为75．0％。治疗有效33例占91．67％，感染直接导致死亡3例占8．3％。感染部位以呼吸道最为常见，共16例占44．44％，其次为消化道感染8例占22．22％，肛周感染5例占13．89％，泌尿系感染3例占8．33％，其他部位如皮肤等感染4例占11．11％。病原学检查分离培养出病原菌44株，其中G-杆菌27株占61．36％，G＋球菌17株占38．64％，真菌6例占13．64％。结论急性白血病患者化疗后粒细胞缺乏合并医院感染的发生率高，在应用粒细胞集落刺激因子同时合理使用抗菌药物是控制医院感染的有效方法。
目的：分析總結急性白血病患者化療後粒細胞缺乏伴醫院感染的臨床特點，便于指導臨床用藥。方法迴顧總結48例急性白血病住院患者化療後併髮感染，採用“降階梯治療”的策略，閤理應用抗菌藥物等治療的相關臨床資料。結果48例急性白血病患者化療後髮生醫院感染36例，感染率為75．0％。治療有效33例佔91．67％，感染直接導緻死亡3例佔8．3％。感染部位以呼吸道最為常見，共16例佔44．44％，其次為消化道感染8例佔22．22％，肛週感染5例佔13．89％，泌尿繫感染3例佔8．33％，其他部位如皮膚等感染4例佔11．11％。病原學檢查分離培養齣病原菌44株，其中G-桿菌27株佔61．36％，G＋毬菌17株佔38．64％，真菌6例佔13．64％。結論急性白血病患者化療後粒細胞缺乏閤併醫院感染的髮生率高，在應用粒細胞集落刺激因子同時閤理使用抗菌藥物是控製醫院感染的有效方法。
목적：분석총결급성백혈병환자화료후립세포결핍반의원감염적림상특점，편우지도림상용약。방법회고총결48례급성백혈병주원환자화료후병발감염，채용“강계제치료”적책략，합리응용항균약물등치료적상관림상자료。결과48례급성백혈병환자화료후발생의원감염36례，감염솔위75．0％。치료유효33례점91．67％，감염직접도치사망3례점8．3％。감염부위이호흡도최위상견，공16례점44．44％，기차위소화도감염8례점22．22％，항주감염5례점13．89％，비뇨계감염3례점8．33％，기타부위여피부등감염4례점11．11％。병원학검사분리배양출병원균44주，기중G-간균27주점61．36％，G＋구균17주점38．64％，진균6례점13．64％。결론급성백혈병환자화료후립세포결핍합병의원감염적발생솔고，재응용립세포집락자격인자동시합리사용항균약물시공제의원감염적유효방법。
Objective To analyse and summarize the clinical characteristics of acute leukemia and chemotherapy induced agranulocytosis associated with hospital infections so as to direct clinical medication. Methods The clinical data of 48 cases of acute leukemia and chemotherapy induced agranulocytosis associated with hospital infection received “de-escalation therapy” and rational antibacterials therapy. Results Among the 48 patients,36 of acquired hospital infection after chemotherapy,infection rate was 75.0%; 33 were cured(91.67%),3 died due to very severe infection (8.3%). Respiratory tract infection occupied 44.44% being in the most proportion,secondaryly 8 of alimentary infection,5 from crissum infection (13.89%),3 from urinary system infection (8.33%),the other site infection in 4 cases (11.11%) were as skin infection and so on. Forty-four strains of pathogenic bacteria were isolated and cultured for etiology examination,including 27 strains of G- bacilli(61.36%), 17 strains of G+ coccus(38.64%),6 strains of fungi(13.64). Conclusion There is a high rate in acute leukemia chemotherapy induced agranulocytosis complicated with hospital infections. Rational use of antibacterials,at the same time,of granulocyte colony-stimulating factor is an effective control to the hospital infection.
