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目的:分析儿童急性白血病化疗后由外周血中性粒细胞的减少所引起的医院感染,为医院感染防治措施的制定提供客观依据。方法:对我院血液科2001年1月~2004年12月住院的40例均由临床、血象、骨髓细胞学检查确诊并接受治疗的急性白血病患儿进行研究统计。结果:本组40例530例次化疗患儿中,发生感染144例次,感染例次率为27·1%,发生医院感染70例次,占总感染例次的48·6%,感染部位及器官以呼吸道、胃肠道、败血症、皮肤及口腔多见;病人外周血中性粒细胞计数≤0·1×109/L发生感染107例次,占总感染例次的74·3%;外周血中性粒细胞计数为0·1~0·5×109/L发生感染29例次,占总感染例次约20·1%;外周血中性粒细胞计数为0·5~1·0×109/L发生感染6例次,占总感染例次的4·1%;外周血中性粒细胞计数>1.0×109/L发生感染2例次,占总感染例次的1·4%。结论:儿童急性白血病医院感染率高,因此,预防和控制医院感染是提高儿童急性白血病治疗水平和延长患儿生存期的重要手段;外周血中性粒细胞减少及继发免疫功能低下,使患儿并发医院感染发生率高、程度重、范围广;因此,外周血中性粒细胞减少是并发医院感染的独立危险因素之一。
Objective: To analyze the nosocomial infection caused by the reduction of peripheral blood neutrophils after chemotherapy for childhood acute leukemia, and to provide an objective basis for the establishment of prevention and treatment measures for nosocomial infections. Methods: 40 cases of hospitalized patients with hematology in our hospital from January 2001 to December 2004 were studied by clinical, hemogram and bone marrow cytology examination and treated children with acute leukemia. Results: In this group of 40 cases of 530 cases of chemotherapy in children, 144 cases of infection, the infection rate was 27.1%, 70 cases of hospital infection occurred, accounting for 48.6% of the total number of cases of infection, the site of infection And organs were common in the respiratory tract, gastrointestinal tract, sepsis, skin and oral cavity. The number of patients with peripheral blood neutrophil count ≤0.1 × 109 / L was 107 cases, accounting for 74.3% of the total cases. Peripheral blood neutrophil count was 0 · 1 ~ 0 · 5 × 109 / L infection in 29 cases, accounting for about 20.1% of cases of total infection; peripheral blood neutrophil count was 0.5 · 1 · 0 × 109 / L infection occurred in 6 cases, accounting for 4.1% of the total infection cases; peripheral blood neutrophil count> 1.0 × 109 / L infection in 2 cases, accounting for the total number of cases of infection 1.4 %. Conclusion: Hospital infection rate of acute leukemia in children is high. Therefore, prevention and control of nosocomial infection is an important means to improve children’s acute leukemia treatment and extend the survival of children. Peripheral neutropenia and secondary immune dysfunction, Children with concurrent high incidence of hospital infection, the degree of heavy, wide range; therefore, peripheral blood neutropenia is an independent risk factor for nosocomial infections.