造血干细胞移植感染并发症防治的临床研究

目的 总结分析我院造血干细胞移植感染并发症的发生及防治情况，提出造血细胞移植感染防治的策略。方法 对我院1984年9月－1998年3月收治的150例次各种类型造血干细胞移植病例感染并发症的发生及防治情况，根据移植类型、感染发生与否、预防用药、病原学及感染部位等分组进行统计学分析。结果 全部150例次病感染的发生率为89．3％，共3例患者死于感染，感染死亡率为2％，这3例均为真菌感染，80例预防或治疗中用过亚胺培南／西司他丁（泰能）或头孢他啶的病例，真菌感染发生率为32．5％，而未用过亚胺培南／西司他丁或头孢他啶的病例真菌感染的发生率仅15．7％，P＜0．02。结论 预防性应用广谱强力的抗生素并不能减少感染发生率，反而可能增加真菌感染的机会。

Clinical Research on Infectious Complications after Hematopoietic Stem Cell Transplantation

OBJECTIVE To evaluate retrospectively the incidence and treatment of infectious complications within the first 60 days after hematopoietic stem cell transplantation,and to find more efficient anti-infective regimens. METHODS To study the incidence,pathogenic microorganism,prophylaxis,treatments of infectious complications in 150 patients accepted hematopoietic stem cell transplantation from April 1984 to March 1998 in our hospital.The results were analyzed statistically.RESULTS Incidence of infectious complications was 89.3% in all 150 cases.Three patients(2%) died of the fungal infection.The incidence of the infections was 32.5% in patients accepted treatment with imipenem or／and ceftazidine,and 15.7% in other patients without the treatment with imipenem or／and ceftazidine(P＜0.02).CONCLUSIONS The strong antibacterial prophylaxis can′t reduce the incidence of infection,and may increase the chance of fungal infection.