多发性骨髓瘤患者医院感染相关因素分析

目的：探讨多发性骨髓瘤患者医院感染的临床特点及危险因素.方法：对2009年10月-2013年2月收治的328例多发性骨髓瘤患者医院感染的临床资料进行回顾性分析.结果：328例患者中152例发生医院感染,感染率为46.3%,粒细胞缺乏组的医院感染率为91.3%,显著高于非粒细胞缺乏组（P＜0.01）.感染部位以下呼吸道、口腔、胃肠道和泌尿道等为主.致病菌以革兰氏阴性杆菌、革兰氏阳性球菌和真菌为主.MP方案化疗患者的感染率（23.9%）与VAD和BD组（68.5%和65.3%）相比有显著性差异（P＜0.01）.结论：多发性骨髓瘤患者医院感染的发生与粒细胞缺乏、化疗方案及住院时间等因素有关,应用全环境保护及粒细胞集落刺激因子可减少医院感染的发生.

Related factor of nosocomial infection in multiple myeloma patients

Objective：To investigate clinic status and risk factors of nosocomial infection in multiple myeloma （MM）. Methods：Retrospectively studied 328 patterers with MM from October 2009 to February 2013. Results： A- mong 328 patients with MM, 152 patients（46.3% ） suffered from nosocomial infections. The incidence of nosocomial infections （91.3% ） in the agranulocytosis group was significantly higher than those in the non - agranulocytosis group （P 〈 0.01）. Most of nosocomial infections took place in the low respiratory tract followed by oral cavity,gastrointesti- nal tract and urinary tract. The major infective microorganisms were gram - negative bacilli, gram - positive cocci and fungi. The incidence rate of infections in patients treated with the MP protocals was 23.9% ,which was significantly different froln those in patients treated with the VAD and BD protoeals. Condusion：Nosocomial infection rate of MM was related to the agranulocytosis, chemotherapy and hospitalization doys. Using total environmental protection and granulocyte colony stimulating factor could decrease the risk of nosocomial infection.