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目的 了解在常规抗生素预防方案基础上加用亚胺培南 /西司他丁对造血干细胞移植早期感染发生的影响。方法 观察中山大学附属第二医院儿科造血干细胞移植中心 1998年 1月至 2001年 12月收治的 12例亚胺培南 /西司他丁预防组和 12例常规抗生素预防对照组的造血干细胞移植患儿移植早期感染发生的种类、病原体培养结果、感染发生和控制时白细胞数变化以及移植早期感染发生的天数和持续时间等资料,采用t检验和非参数检验进行统计分析。结果 所有 24例患儿首次感染均发生在中性粒细胞绝对计数 >0 5×109 /L之前;移植早期感染最常见为呼吸道感染和口腔炎、胃肠炎等消化道黏膜炎。加用亚胺培南 /西司他丁组首次感染发生的时间[ (8 75±4 61)d]较常规对照组[ (4 67±2 31)d]明显推迟;亚胺培南 /西司他丁预防组患儿外周血白细胞均数(0 55×109 /L)感染发生时显著高于对照组(0 09×109 ),差异有显著性。结论 移植前在常规抗生素预防方案基础上加用亚胺培南 /西司他丁可以推迟移植早期感染的发生时间,对移植早期感染的预防有一定的效果。
Objective To understand the effect of adding imipenem / cilastatin on the early infection of hematopoietic stem cell transplantation on the basis of routine antibiotic prophylaxis. Methods 12 cases of imipenem / cilastatin prophylaxis group and 12 cases of conventional antibiotic prophylaxis group were enrolled in the pediatric hematopoietic stem cell transplantation center of the Second Affiliated Hospital of Sun Yat-sen University from January 1998 to December 2001 T-test and nonparametric test were used to analyze the types of early infection, the pathogen culture results, the number of white blood cells during infection and control, the number of days and duration of early transplant infection. Results All 24 patients had the first infection before neutrophil count> 0 5 × 109 / L. The most common infection in early transplantation was respiratory tract infection and stomatitis, gastroenteritis and other gastrointestinal mucositis. The time of initial infection with imipenem / cilastatin was significantly delayed (8 75 ± 4 61) d compared with that of the control group [(67 67 ± 2 31) d], and imipenem / Stanin prophylaxis group children with peripheral blood leukocytes (0 55 × 109 / L) infection was significantly higher than the control group (0 09 × 109), the difference was significant. Conclusion Adding imipenem / cilastatin to routine antibiotic prophylaxis before transplantation may delay the onset of early-stage transplant infection and have some effect on the prevention of early-stage transplant infection.