CAJ | 학술논문

目的：分析恶性血液病患者院内感染的危险因素及病原菌特点。方法：对我院血液科3年来收治的956例恶性血液病患者中发生院内感染的139例进行回顾性分析。结果：院内感染发生率为14．54％，感染部位依次为呼吸道、血液、胃肠道为主。通过单因素分析发现，院内感染与患者年龄、住院天数、疾病状态、粒细胞缺乏、粒细胞缺乏持续时间及血红蛋白数值、血小板数值、白蛋白含量、激素使用、是否接受化疗有关。通过多因素分析发现，疾病状态、粒细胞缺乏持续时间、住院时间是院内感染的独立危险因素。病原菌以革兰阴性杆菌为主，多对亚胺培南及头孢哌酮舒巴坦敏感。其次为真菌及革兰阳性菌。结论：恶性血液病患者为院内感染高危人群，降低其院内感染发生率的最主要方法是缩短粒细胞缺乏时间，缩短住院时间和提高恶性血液病的治疗效果。
목적：분석악성혈액병환자원내감염적위험인소급병원균특점。방법：대아원혈액과3년래수치적956례악성혈액병환자중발생원내감염적139례진행회고성분석。결과：원내감염발생솔위14．54％，감염부위의차위호흡도、혈액、위장도위주。통과단인소분석발현，원내감염여환자년령、주원천수、질병상태、립세포결핍、립세포결핍지속시간급혈홍단백수치、혈소판수치、백단백함량、격소사용、시부접수화료유관。통과다인소분석발현，질병상태、립세포결핍지속시간、주원시간시원내감염적독립위험인소。병원균이혁란음성간균위주，다대아알배남급두포고동서파탄민감。기차위진균급혁란양성균。결론：악성혈액병환자위원내감염고위인군，강저기원내감염발생솔적최주요방법시축단립세포결핍시간，축단주원시간화제고악성혈액병적치료효과。
Objective:To analyze the risk factors and pathogens distribution in patients with malignant hematological diseases .Methods:A retrospective a-nalysis was conduct in 956 nosocomial cases with malignant hematological diseases .Results:The occurrence of the nosocomial infection was 14 .54%, and the infection was consequentially associated with respiratory infection, blood and gastrointestinal tract.Single factor analysis showed that the incidence of nosocomial infection was related to the patient′s age, days of hospital stay, status of disease, agranulocytosis and its duration, hemoglobin level, platelet count, albumin content, use of glucocorticoid, and history of chemotherapy.Multiple regression analysis showed that disease status, angranulocytosis du-ration and hospital stay duration were independent risk factors.The main pathogens were associated with gram-negative bacillus, primarily responded to imipenem and ceforperazone shubatan, followed by fungus and gram-positive coccus.Conclusion:Nosocomial infection appears highly prevalent in patients with malignant hematological disease, and the effective way to check this infection relies mainly on controlling of the angranulocytosis persistence and re-duced hospital stay as well as improved efficacy for this disease .