老年急性髓系白血病患者化疗后医院感染病原学、危险因素分析及预防

目的 研究老年急性髓系白血病(AML)患者医院感染的病原学、危险因素,并探讨其预防措施.方法 91例老年AML患者接受化疗304例次,对其医院感染发生率、感染部位、病原学检测结果、中性粒细胞绝对值、粒细胞缺乏持续时间与医院感染发生率的关系进行分析,并与非老年组AML患者进行比较.结果 老年AML患者较非老年患者医院感染的统计指标增高.下呼吸道、口腔、消化道、皮肤、肛周感染及败血症发生率老年组均高于非老年组.真菌感染检出率老年组高于非老年组.中件粒细胞绝对值<0.5×109/L的患者中粒细胞缺乏持续时间>7d者医院感染发生率较高.结论 老年白血病患者是医院感染的高危人群.年龄、化疗因素、中性粒细胞减少程度及持续时间是导致老年AML医院感染的危险因素,针对上述危险因素积极采取有效预防措施对降低患者医院感染率是十分必要的.

The analysis and the prevention of nosocomial infection and the risk factors in senile patients with acute myelogenous leukemia after chemotherapy

Objective To study the etiology of nosocomial infection and the risk factors in senile patients with acute myelogenous leukemia who received chemotherapy, then to explore the preventive measure. Methods 9lcases of senile patients with AML received 304 times of chemotherapy, then to analyze the rate of nosocomial infection, the infection site, the result of etiological examination and the relationship between the rate of nosocomial infection and the absolute of neutrophil count in peripheral blood and the duration of agranulocytosis. And then the results were compared with the non-senile patients with AML. Results The statistical indicators of nosocomial infection in senile patients with AML was higher than those younger ones. The rate of infection in lower respiratory tract, oral, alimentary canal, skin, anal area and the rate of sepsis in senile people was higher than those younger ones.Positive rate of fungal infection of senile patients was higher. The nosocomial infection in the patients whose absolute neutrophil count in peripheral blood was no more than 0.5×l09/L,and prolonged over 7 days was specific higher. Conclusions Senile patients with AML is the high risk group for nosocomial infection. Age, chemotherapy, the neutrocytopenia level and prolonged time are related to the nosocomial infection in senile patients with AML. It is necessary to take positive measure to control nosocominal infection and advance life quality of senile patients.