儿童急性白血病合并呼吸道感染的危险因素及预防性护理措施分析

  目的  对儿童急性白血病(AL)合并呼吸道感染的危险因素进行分析，通过结果提出预防护理措施，为临床治疗提供参考。  方法  回顾性分析2018年2月—2021年2月温州医科大学附属第二医院收治的140例儿童AL患者，分为呼吸道感染组(72例)和非呼吸道感染组(68例)。收集患者的相关临床资料，分析影响儿童AL合并呼吸道感染的危险因素，并提出预防性护理措施。  结果  重度贫血、白细胞计数＞10×109/L或＜2×109/L、血小板＜20×109/L、低蛋白血症、住院时间延长、化疗方案、预防性应用抗生素是儿童白血病合并呼吸道感染的影响因素(均P＜0.05)；多因素logistic回归分析显示重度贫血(OR=2.440, 95% CI:1.073~5.546)、血小板＜20×109/L(OR=1.972, 95% CI:1.061~3.663)、低蛋白血症(OR=2.959, 95% CI:1.115~7.853)、IA化疗方案(OR=3.799, 95% CI:1.207~11.957)是影响儿童AL合并呼吸道感染的独立危险因素。  结论  儿童AL合并呼吸道感染的危险因素包括重度贫血、血小板＜20×109/L、低蛋白血症、IA化疗方案，临床需针对上述危险因素采取预防性护理措施。 

Risk factors and preventive nursing measures of acute leukaemia complicated with respiratory tract infection in children

  Objective  To analyse the risk factors of acute leukaemia (AL) complicated with respiratory tract infection in children and to propose preventive nursing measures based on the results, thereby providing reference for clinical treatment.  Methods  A retrospective analysis was performed on 140 paediatric AL patients admitted to the Second Affiliated Hospital of Wenzhou Medical University from February 2018 to February 2021, who were divided into the respiratory tract infection group (72 cases) and non-respiratory tract infection group (68 cases). Relevant clinical data of the patients were collected to analyse the risk factors affecting children with AL complicated with respiratory tract infection, and the preventive nursing measures were proposed.  Results  Severe anaemia, white blood cell count >10×109/L or < 2×109/L, platelet < 20×109/L, hypoproteinaemia, prolonged hospital stay, chemotherapy regimen and prophylactic use of antibiotics were the influencing factors of paediatric leukaemia complicated with respiratory tract infection (all P < 0.05). Multivariate logistic regression analysis showed that severe anaemia (OR=2.440, 95% CI: 1.073-5.546), platelet < 20×109/L (OR=1.972, 95% CI: 1.061-3.663), hypoproteinaemia (OR=2.959, 95% CI: 1.115-7.853) and IA chemotherapy regimen (OR=3.799, 95% CI: 1.207-11.957) were independent risk factors for AL complicated with respiratory tract infection in children.  Conclusion  The risk factors of children with AL complicated with respiratory tract infection include severe anaemia, platelet < 20×109/L, hypoproteinaemia and IA chemotherapy regimen, and preventive nursing measures should be taken in accordance with the above-mentioned risk factors in clinic.