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目的分析成人血液系统恶性肿瘤患者接受强烈化疗后中性粒细胞减少性肠炎(NE)的发生率、危险因素及预后情况。方法收集2004至2013年接受化疗的1 804例血液系统恶性肿瘤患者,记录患者血常规、凝血检测和血液生化检测结果,并记录患者年龄、性别、原发病、既往化疗次数、既往化疗方案中是否使用阿糖胞苷、临床症状、肠壁厚度、中性粒细胞最低计数、中性粒细胞缺乏持续时间、NE的治疗方法和预后等,探讨NE起病诱因、临床特征、腹部B超特点、症状的预后意义及化疗药物对发病的影响等。结果 1 804例患者中226例(12.5%)化疗后合并NE,化疗后10~19d起病,中位起病时间为化疗后第14天。发生NE后26例患者死亡,病死率11.5%。化疗药物包括阿糖胞苷、临床症状≥4项、中性粒细胞缺乏持续超过7d以及B超下肠壁厚度≥10mm的患者病死率相对较高。结论 NE是接受强烈化疗的血液系统肿瘤患者的严重的并发症,发生NE后患者病死率较高。
Objective To analyze the incidence, risk factors and prognosis of neutropenic enteritis (NE) in patients with adult hematological malignancies after intensive chemotherapy. Methods A total of 1 804 patients with hematological malignancies undergoing chemotherapy were enrolled in this study. Blood samples, blood coagulation tests and blood biochemical tests were recorded. The patients’ age, gender, primary disease, previous chemotherapy times, previous chemotherapy regimens Whether to use cytarabine, clinical symptoms, intestinal wall thickness, the lowest count of neutrophils, the duration of neutropenia, the treatment of NE and prognosis, to explore the causes of NE onset, clinical features, abdominal ultrasonography The prognostic significance of symptoms and the impact of chemotherapy drugs on the incidence and so on. RESULTS: Of the 1 804 patients, 226 (12.5%) had NE after chemotherapy and ten to 19 days after chemotherapy. The median onset time was 14 days after chemotherapy. Twenty-six patients died after NE occurred, with a mortality rate of 11.5%. Chemotherapy drugs including cytarabine, clinical symptoms ≥ 4 items, neutropenia lasted for more than 7d and B ultrasonographic wall thickness ≥ 10mm patients with relatively high mortality. Conclusions NE is a serious complication of hematological malignancies in patients undergoing intensive chemotherapy, with a higher case-fatality rate following NE.