儿童急性淋巴细胞白血病诱导化疗期间院内感染20例

目的探讨急性淋巴细胞白血病诱导化疗期间院内感染的临床特点,总结治疗经验。方法分析20例初发急性淋巴细胞白血病患儿诱导化疗期间院内感染的临床资料。结果院感率高达95%,皮肤粘膜和呼吸道为最常见感染部位,常见的病原菌为G-菌;中性粒细胞绝对值≤0.2×109/L者,感染发生距化疗开始的时间早,发热持续时间长;所有感染均采用广谱杀菌剂,其中7例发生真菌感染;除1例中途放弃外,18例均控制感染,19例获得缓解。结论急性淋巴细胞白血病患儿采用2006年全国ALL方案诱导化疗期间,骨髓缓解率高,但感染发生率高,感染程度重,真菌感染的概率大,及时而强有力的抗感染能有效提高患儿的生存率。

Nosocomial infection in 20 children with acute lymphoblastic leukemia during induction chemotherapy

Objective To explore the clinical characteristics of nosocomial infection in children with acute lymphoblastic leukemia during induction chemotherapy,and provide the experience of treatment.Methods The clinical data of 20 children with ALL suffered nosocomial infection during inducting chemotherapy were analyzed.Results Nosocomial infection rate was 95%,the skin and mucosa,and the respiratory tract were the most frequently sites infected,the most common causal organism was gram-negative bacteria;when absolute neutrophil count ≤0.2*109/L,the infection occoured early,and the fever duration was long.All infected children had been administrated broad spectrum antibiotics,and 7 children infected fungus;of 20 children,one droped out,the infections in the remain 18 children had been controlled,and 19 children gained remission.Conclusion The marrow remission rate was high giving National ALL Protocol 2006 induction chemotherapy,but the nosocomial infection rate was also high,the infection was severe,with high infection of fungus.The survival could be improved through timely and effective anti-infection treatment.