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目的 为了探讨恶性血液病患者医院感染与外周血白细胞数的关系及其感染病原学特点 ,为临床防治提供依据。方法 对我院 1996～ 2 0 0 0年共收治的 5 2 6例恶性血液病住院患者进行回顾性调查分析。结果 5 2 6例恶性血液病患者 ,有 2 74例发生医院感染 ,感染率为 5 2 .0 9% ;白细胞数 <4 .0× 10 9/L组感染率 6 3.0 2 %、<1.0×10 9/L组感染率 95 .2 8%、≥ 4 .0× 10 9/L组感染率 16 .2 6 % ,与前两组比较 P<0 .0 0 1;白细胞数≤ 1.0× 10 9/L感染死亡率 4 6 .5 3%、>1.0× 10 9/L 感染死亡率 8.0 9% ,两组间比较 P<0 .0 0 1;感染的病原菌主要是铜绿假单胞菌、大肠埃希菌及肺炎克雷伯菌 ,其次为真菌。结论 白细胞减少是恶性血液病患者医院感染的主要危险因素 ,对白细胞数 <1.0× 10 9/L 的患者应加强护理 ,对病原菌应根据敏感药物合理使用抗生素 ,慎用广谱抗生素 ,以防真菌感染。
Objective To investigate the relationship between nosocomial infection and peripheral blood leukocyte count in patients with hematologic malignancies and the etiological characteristics of the infection, and to provide evidence for clinical prevention and treatment. Methods Retrospective analysis was performed on 526 patients with hematologic malignancies hospitalized in our hospital from 1996 to 2000. Results Among 526 patients with hematologic malignancies, 2 74 cases had nosocomial infection with an infection rate of 52.09%. The infection rate of white blood cell count <4 .0 × 10 9 / L was 6.030% and <1.0 × The infection rate of 10 9 / L group was 95.28%, the infection rate of ≥ 4 .0 × 10 9 / L group was 16.26%, P <0.01, the number of white blood cells was less than 1.0 × 10 The mortality rate of 9 / L infection was 46.53%, and the infection mortality rate was 8.09%> 1.0 × 10 9 / L, P <0.01. The main pathogens of infection were Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae, followed by fungi. Conclusions Leukopenia is the main risk factor of nosocomial infection in patients with hematologic malignancies. Patients with white blood cell count <1.0 × 10 9 / L should be intensively nurtured. Antibiotics should be used according to sensitive drugs reasonably, and broad-spectrum antibiotics should be used with caution to prevent fungi infection.