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[目的]探讨影响急性白血病(AL)感染败血症的危险因素,并对产生的病原菌进行药敏研究,为治疗继发败血症提供临床依据。[方法]对温州市中心医院2004年12月—2010年1月73例继发败血症的急性白血病患者临床资料进行回顾研究,将9种可能引起败血症的危险因素进行统计分析,再建立logistic回归模型;将病原菌分离后进行药敏实验,观察细菌分布及耐药情况。[结果]从9种可能的危险因素中筛选出5种主要的危险因素,分别为使用抗生素、年龄、住院时间、手术时间及白细胞计数;利用纸片扩散法(K-B法)检测细菌耐药情况,发现该院白血病继发败血症的细菌耐药情况十分严重。[结论]使用抗生素、年龄、住院时间、手术时间和白细胞计数是急性白血病继发败血症的独立危险因素,需要加强管理,尤其是对抗生素要加强使用规范,倡导合理用药。
[Objective] To explore the risk factors affecting sepsis in acute leukemia (AL) infection and to study the susceptibility of the pathogens produced to provide a clinical basis for the treatment of secondary sepsis. [Methods] The clinical data of 73 patients with acute leukemia secondary to septicemia from December 2004 to January 2010 in Wenzhou Central Hospital were retrospectively analyzed. Nine risk factors that may cause sepsis were statistically analyzed, and then a logistic regression model was established ; After the pathogen isolated susceptibility testing, observation of bacterial distribution and drug resistance. [Results] Five major risk factors were screened from 9 possible risk factors, including antibiotic use, age, hospitalization time, operation time and white blood cell count. Bacterial drug resistance was detected by disk diffusion method (KB method) Found that the hospital secondary leukemia secondary to bacterial resistance is very serious. [Conclusion] The use of antibiotics, age, length of hospital stay, operation time and white blood cell count are independent risk factors for secondary septicemia in acute leukemia, and need to be strengthened management, especially for antibiotics to strengthen the use of norms and promote rational drug use.