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目的探讨肿瘤患儿化疗相关感染早期临床表现与感染严重程度的关系,寻找早期提示重症感染的线索。方法 2005年10月至2009年1月在中山大学附属第一医院儿科化疗并发生化疗相关感染的肿瘤患儿136例,共发生感染346例次,比较重症感染与轻症感染患儿早期临床表现的差异。结果重症感染133例次,轻症感染213例次。重症感染患儿早期伴畏寒、寒战、精神欠佳、末梢循环不良、粒细胞缺乏的患儿明显多于轻症感染患儿,且热峰及发热6～12hC-反应蛋白(CRP)值均较轻症感染患儿高;接受强化疗患儿中,感染早期伴畏寒、寒战、精神欠佳、末梢循环不良、中性粒细胞计数≤0.5×109/L、CRP≥40mg/L、热峰≥39.5℃的患儿发生重症感染的机会大于无上述表现者,差异有统计学意义(P<0.05)。结论接受强化疗及感染早期伴畏寒、寒战、精神欠佳、末梢循环不良、中性粒细胞计数≤0.5×109/L、CRP≥40mg/L、热峰≥39.5℃患儿易发展为重症感染。
Objective To investigate the relationship between the early clinical manifestations and the severity of infection in children with cancer and to find the clues for early warning of severe infections. Methods From October 2005 to January 2009, 136 children with chemotherapy-induced chemotherapy-related chemotherapy and chemotherapy in the First Affiliated Hospital of Sun Yat-sen University received a total of 346 cases of infection. The early clinical manifestations of severe infection and mild infection were compared The difference. Results 133 cases of severe infection, 213 cases of mild infection. Children with severe infection in early with aversion to chills, poor health, poor peripheral circulation, agranulocytosis were significantly more children with mild infection, and peak heat and fever 6 ~ 12hC-reactive protein (CRP) value Children with mild infection had a high level of neutropenia. Patients with intensive chemotherapy had early infection with aversion to chills, chills, poor psychosis, poor peripheral circulation, neutrophil count ≤0.5 × 109 / L, CRP ≥40 mg / L, The chances of severe infection in children with peak ≥39.5 ℃ were higher than those without above-mentioned symptoms (P <0.05). Conclusions The patients with intensive chemotherapy and early infection who suffer from chills, chills, poor psychosis, poor peripheral circulation, neutrophil count ≤0.5 × 109 / L, CRP≥40 mg / L and fever peak≥39.5 ℃ are likely to develop severe disease infection.