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目的:分析急性白血病患者化疗后医院感染的致病菌分布及其抗感染药物治疗方法和预防措施。方法:采用回顾性分析法,选取2015年1—12月间收治的急性白血病患者54例资料,分析化疗后患者医院感染的发生及其治疗对策。结果:54例急性白血病患者中发生医院感染人数为42例,其感染率为77.78%;直接死于感染的患者12例,感染病死率为22.22%;大于60岁患者感染率大于<60岁患者(P<0.05);中性粒细胞计数>1.5×10~9/L组,感染发生率明显低于中性粒细胞计数<0.5×10~9/L组(P<0.05);采用氟康唑加G-CSF的联用组患者的发热时间、中性粒细胞计数恢复至>1.5×10~9/L的时间优于单用氟康唑组(P<0.05)。结论:患者年龄>60岁,中性粒细胞计数<0.5×10~9/L是医院感染主要易感因素,采用氟康唑及粒细胞集落刺激因子治疗是合理的,能够降低急性白血病患者化疗后医院感染的发生率,缩短发热时间。
Objective: To analyze the distribution of nosocomial pathogenic bacteria in patients with acute leukemia after chemotherapy and its anti-infective drug treatment and preventive measures. Methods: Retrospective analysis was used to select 54 cases of acute leukemia patients admitted from January to December in 2015, and to analyze the incidence of nosocomial infections and their treatment strategies after chemotherapy. Results: The number of nosocomial infections in 54 cases of acute leukemia was 42 and the infection rate was 77.78%. In 12 cases of direct death from infection, the infection mortality rate was 22.22%. The infection rate in patients over 60 years old was higher than that in patients <60 years old (P <0.05); neutrophil count> 1.5 × 10 ~ 9 / L group, the incidence of infection was significantly lower than the neutrophil count <0.5 × 10 ~ 9 / L group The fever time and the recovery of neutrophil count to> 1.5 × 10 ~ 9 / L were better than fluconazole alone group (P <0.05). CONCLUSIONS: Patients aged> 60 years and neutrophil counts <0.5 × 10 ~ 9 / L are the major risk factors of nosocomial infection. Fluconazole and granulocyte colony-stimulating factor therapy are reasonable and can reduce chemotherapy in patients with acute leukemia The incidence of nosocomial infections, shorten the fever time.