多发性骨髓瘤医院感染46例临床分析

目的：探讨多发性骨髓瘤（MM）患者医院感染的临床特点。方法：回顾性分析我院1996年1月至2000年12月住院治疗的168例多发性骨髓瘤患者的临床资料。结果：168例MM患者发生医院感染46例,感染率27．38,粒细胞缺乏组医院感染率、感染致死率明显高于非粒细胞缺乏组（P＜0．01）。感染部位以呼吸道为主,致病病原体以革兰阴性杆菌、革兰阳性球菌和真菌为主。MP和MVCP方案化疗患者的感染率（20．62％和25．71％）与VAD的M2组的（69．23％和66．67％）相比有显著性差异（P＜0．01）。粒细胞缺乏组平均感染日13．65天高于非粒细胞缺乏组的8．72天（P＜0．05）。结论;多发性骨髓瘤医院感染发病率高,应积极治疗和预防。

Clinical analysis of nosocomial infections for 46 patients with multiple myeloma.

Objective To clarify the features of nosocomial infections for patients with multiple myeloma (MM).Methods One hundred and sixty eight cases of MM treated in our hospital from Jan.1996 to Dec.2000 were analyzed retrospectively.Results Among 168 patients with MM,46 patients (27.38%)suffered from nosocomial infections.The incidence and the case mortality of infections in the granulocytopenia group were significantly higher than those in the non granulocytopenia group(( P <0.01).Most of the infections took place in the respiratory tract ,and the major infective microorganisms were gram negative bacilli,gram positive cocci and fungi.The incidence rates of infections in patients treated with the MP and VMCP protocals were 20.62% and 25.71% respectively,which were significantly different from those in patients treated with the VAD and M 2 protocols(69.23%and 66.67%).The mean duration of nosocomial infections(13.65 days) of the granulocytopenia group was much higher than that(8.72 days)of the non granulocytopenia group.Conclusion The incidence of nosocomial infections in patients with multiple myeloma is high.These patients should be given more active treatments and prophylaxes.