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目的探讨高危急性淋巴细胞白血病患者维持治疗阶段营养状况与医院感染发生率的相关性研究。方法使用自行设计的调查问卷收集2013年1月—2016年6月浙江省人民医院收治的286例高危急性淋巴细胞白血病患者相关资料,采用患者主观整体评估(PG-SGA)法评估患者维持治疗阶段的营养状况,分析患者营养状况与医院感染发生率的相关性。结果 286例高危急性淋巴白血病患者中不需要营养支持104例,需要营养支持182例,其中有98例发生医院感染,占34.27%(98/286);急性淋巴细胞白血病患者医院感染发生率与营养状况呈负相关(r=-0.724,P<0.001);单因素分析显示,住院时间、化疗强度、血红蛋白、白细胞计数、中性粒细胞、抗生素应用种类、白蛋白、抗生素使用时间、PG-SGA评分等差异有统计学意义(P<0.05),年龄、性别、糖皮质激素使用等差异无统计学意义(P>0.05);Logistic多因素回归分析显示:PG-SGA评分、化疗强度、中性粒细胞数、血红蛋白、白蛋白、抗生素使用时间等是高危急性淋巴细胞白血病患者医院感染发生的影响因素。结论高危急性淋巴细胞白血病患者维持治疗阶段的营养状况与医院感染发生率密切相关,患者营养状况是发生医院感染的危险因素。
Objective To investigate the correlation between nutritional status and nosocomial infection in patients with high-risk acute lymphoblastic leukemia during maintenance treatment. Methods A total of 286 high risk acute lymphoblastic leukemia patients admitted to Zhejiang Provincial People’s Hospital from January 2013 to June 2016 were collected using the self-designed questionnaire. Patients’ subjective global assessment (PG-SGA) was used to evaluate the maintenance treatment phase Of nutritional status, analysis of patient nutrition status and the incidence of nosocomial infection. Results Of the 286 patients with high-risk acute lymphoblastic leukemia, no nutritional support was needed in 104 patients and nutritional support was required in 182 patients. Of them, 98 patients developed nosocomial infection, accounting for 34.27% (98/286). The incidence and nutrition of nosocomial infections in patients with acute lymphoblastic leukemia (R = -0.724, P <0.001). Univariate analysis showed that hospitalization time, chemotherapy intensity, hemoglobin, leukocyte count, neutrophil, antibiotic application type, albumin, antibiotic use time, PG-SGA (P <0.05). There were no significant differences in age, sex, glucocorticoid use, etc. (P> 0.05). Logistic regression analysis showed that PG-SGA score, chemotherapy intensity, The number of granulocyte, hemoglobin, albumin and antibiotic use time are the influencing factors of nosocomial infection in high risk acute lymphoblastic leukemia patients. Conclusion The nutritional status of patients with high-risk acute lymphoblastic leukemia during maintenance treatment is closely related to the incidence of nosocomial infection. The nutritional status of patients is a risk factor for nosocomial infection.