急性白血病患儿医院感染的危险因素
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摘要
目的:探讨儿童急性白血病医院感染的危险因素。方法:对2012年1月至2017年1月573例急性白血病患儿的临床资料进行回顾性分析,其中163例发生医院感染,另410例无任何感染,采用单因素和多因素非条件logistic回归分析对儿童急性白血病医院感染的危险因素进行分析。结果:急性白血病患儿医院感染发生率为28.44%(163/573),感染部位主要为口腔及呼吸道。通过logistic多因素分析显示,患儿发生医院感染的独立危险因素为住院时间、中性粒细胞数目、白细胞数目、侵入性操作、化疗周期、未使用抗菌药物、使用激素。结论:住院时间延长,血液中白细胞和中性粒细胞数量减少、接受侵入性操作、未使用抗菌药物、长时间应用激素和长周期的化疗均为急性白血病患儿医院感染的独立危险因素。
Objective: To explore risk factors of hospital infection in children with acute leukemia. Methods: The clinical data of 573 children with acute leukemia were retrospectively analyzed. Among them, 163 patients had hospital infections, but 410 patients had no infections. The univariate and multivariate unconditional logistic regression analysis were used to analyze the risk factors of hospital infection in the children with acute leukemia. Results: The incidence of hospital infection in the children with acute leukemia was 28.44%(163/573), and the infection site was mainly oral cavity and respiratory tract. The logistic multivariate analysis showed that the independent risk factors for hospital infection were hospitalization time, neutrophil count, white blood cell count, invasive procedure, chemotherapy cycle, non-use of antibiotics, and use of hormones. Conclusions: Prolonged hospitalization time, reduced white blood cell and neutrophil counts, invasive procedures, non-use of antibiotics, prolonged use of hormones, and long-term chemotherapy are the independent risk factors for hospital infection in the children with acute leukemia.
Objective: To explore risk factors of hospital infection in children with acute leukemia. Methods: The clinical data of 573 children with acute leukemia were retrospectively analyzed. Among them, 163 patients had hospital infections, but 410 patients had no infections. The univariate and multivariate unconditional logistic regression analysis were used to analyze the risk factors of hospital infection in the children with acute leukemia. Results: The incidence of hospital infection in the children with acute leukemia was 28.44%(163/573), and the infection site was mainly oral cavity and respiratory tract. The logistic multivariate analysis showed that the independent risk factors for hospital infection were hospitalization time, neutrophil count, white blood cell count, invasive procedure, chemotherapy cycle, non-use of antibiotics, and use of hormones. Conclusions: Prolonged hospitalization time, reduced white blood cell and neutrophil counts, invasive procedures, non-use of antibiotics, prolonged use of hormones, and long-term chemotherapy are the independent risk factors for hospital infection in the children with acute leukemia.
引文
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[2]Roux C,Tifratene K,SociéG,et al.Outcome after failure of allogeneic hematopoietic stem cell transplantation inchildrenwith acute leukemia:a study by the sociétéFrancophone de greffe de moelle et de thérapie cellulaire(SFGM-TC)[J].Bone Marrow Transplant,2017,52(5):678-682.
[3]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:22-23.
[4]李芳,黄利华.急性白血病患者医院感染状况及危险因素分析[J].医学临床研究,2016,33(1):2354-2357.
[5]赵芸,郭妍妍,张春霞,等.儿童急性白血病化疗治疗并发口腔溃疡的影响因素分析[J].癌症进展,2017,15(1):97-99.
[6]Sharma M,Sachdeva MUS,Bose P,et al.Haematological profile of patients with mixed-phenotype acute leukaemia from a tertiary care centre of north India[J].Indian J Med Res,2017,145(2):215-221.
[7]Doumbia M,Uwingabiye J,Bissan A,et al.Epidemiological,clinical,cytologic and immunophenotypic aspects of acute leukemia in children:the experience at the hematology laboratory of IBN SINA University Hospital Center[J].Pan Afr Med J,2016,23(1):258.