急性白血病与细菌感染(附135例次分析)

目的 :探讨急性白血病 ( AL )住院患者细菌感染的有关因素及防治对策。　 方法 :对173例急性白血病住院患者的 135例次细菌感染分析了不同类型 AL的感染率、1990年以前及1990年以后 G+及 G-菌感染率和抗生素药敏分析 ,并分析了年龄、住院时间、中性粒细胞绝对计数、粒细胞缺少持续时间和糖皮质激素的应用等因素对继发感染的影响。　 结果 :ANL L中 M6及M1感染率最高 ,而 M3的感染率最低。>51岁的感染率显著高于 <51岁的感染率。住院时间愈长 ,感染的机率愈大。外周中性粒细胞绝对计数 ( ANC)越低 ,感染的机率越高。粒细胞缺少持续时间越长 ,感染的机率越大。使用皮质激素的患者较未使用的感染机率高。细菌感染 G-菌感染率仍高于G+菌 ,其中以铜绿假单胞菌最多见。G+菌及 G-菌药敏分析以舒普深最佳。　 结论 :对 AL患者感染治疗成功的因素 ,除了恰当使用抗菌药物 ,加强支持治疗 ,改善机体免疫状态及保证足够的能量供应外 ,粒细胞缺少的解除是关键环节

Acute leukemia with bacterial infection:An analysis of1 35 espisodes

Objectives:To study the related factors and the strategies against Bacterial infec- tion in acute leukemia(AL) .Methods:Bacterial infection rate in different types of AL,rate of infection before and after 1 990 ,and drug sensitivty of antibiotics were analyzed. Age,du- ration of hospitalizat ion,absolute neutrophil count,duration of neutropenia and the use of corticosteroid were also analyzed with regard to secondary bacterial infection.Results:In AL ,M6and M1 had the highestinfection rate.Patients over5 1 years old had a significanthigher rate of infection than those under 5 1 .The longer the hospital stay,the higher the infection rate.The lower the absolute neutrophil count(ANC) of peripheral blood,the higher the in- fection risk.Patients using corticosteroid had a higher rate of infection.Pseudomonas aerug- inosa was the most common G- organism. The result of drug sensitivity test to G+and G- organisms showed that Sulperazone was the best antibiotics.Conclusion:The control of in- fection in AL was dependent on the efficient therapy against tumor,normal function of bone marrow ,recovery of immunological function and the properly use of antibiotics.