急性白血病患者诱导缓解期医院感染分析

目的：探讨急性白血病（AL）诱导缓解期医院感染的临床特征及易感因素，为临床干预提供理论基础。方法：回顾性分析2011年2月至2015年9月在温州市中心医院接受诱导缓解治疗的AL患者109例的临床资料，对发生医院感染的感染部位、致病菌和易感因素进行统计分析。结果：AL患者诱导缓解期医院感染率71.56%，感染部位以下呼吸道（占27.72%）为主，致病菌以革兰阴性杆菌为主。单因素分析示，年龄、白血病类型、中性粒细胞计数、粒细胞缺乏天数、住院天数、合并慢性基础疾病与AL诱导缓解期医院感染具有相关性（P＜0.05）；多因素logistic回归分析示，年龄、中性粒细胞计数、住院天数、合并慢性基础疾病是独立危险因素。结论：年龄、中性粒细胞计数、住院天数、合并慢性基础疾病是AL诱导缓解期医院感染的独立危险因素，应针对它们采取有效的防护措施。

Analysis for nosocomial infections in patients with induction period of acute leukemia

Objective: To explore the clinical features and risk factors for nosocomial infection of patients with acute leukemia in induction period, so as to provide the theoretical basis for clinical intervention. Methods: One hundred and nine patients with acute leukemia in Wenzhou Central Hospital from February 2011 to September 2015 treated by remission induction chemotherapy were retrospectively analyzed to research the distribution of infection, pathogenic bacteria and risk factors for nosocomial infection. Results: The nosocomial infection rate of patients with acute leukemia in induction period was 71.56%, and the main part was the lower respiratory tract infection accounting for 27.72%. Gram negative bacilli were the major pathogens. The univariate analysis revealed that the incidence of nosocomial infection with acute leukemia in induction period was associated with age, leukemia type, neutrophil count, agranulocytosis time, days of hospitalization and chronic basic diseases (P<0.05); The multivariate logistic regression analysis indicated that age, neutrophil count, days of hospitalization and chronic basic disease were independent risk factors. Conclusion: Age, neutrophil count, days of hospitalization and chronic basic disease are independent risk factors for patients with acute leukemia in induction period, therefore efficacious protective steps should be taken against these factors.