263例急性白血病患者合并感染临床分析与对策

目的探讨急性白血病患者合并感染的发病率、易感因素及感染的好发部位。方法回顾性分析263例次急性白血病患者的临床资料。结果急性白血病合并感染发生率56·3%,其中院外感染率占61·5%,院内感染率占38·5%。致病菌中以金黄色葡萄球菌及革兰阴性杆菌为主。易感因素与患者年龄、粒细胞减少、化疗药物及免疫抑制剂的使用有关。感染部位以上呼吸道最常见。结论急性白血病患者感染的发生率较高,当患者出现发热时应警惕感染的发生,尤其对儿童、老年人和粒细胞缺乏者,在治疗过程中应采取保护措施,给予支持治疗,尽早使用广谱高效抗生素。

Clinical Analysis and Treatment of 263 Patients with Acute Leukemia Combined with Infection

Objective To research the morbidity, predisposing factors and predilection sites of infection in patients with acute leukemia.Methods To retrospectively analyze the medical data of 263 patients with acute leukemia.Results The morbidity of infection in patients of acute leukemia was 56.3 %, among which the ratio of community infection was 61.5 %, the hospital onset of infection account for 38.5 %. The most important pathogenic bacteria were S.aureas and gram negative bacilli. The predisposing factors consisted of patient's age, granulocytopenia, administration of chemotherapeutics and immunosuppressive agents. The upper respiratory tract infections were predominated.Conclusions The incidence of infection in the patients with acute leukemia is high, especially when the patients have fervescence .During the process of treatment, we must pay more attention to children, aged people or the individuals with agranulocytosis, adopt protective measures, use a broad-spectrum and effective antibiotic as early as possible.