| 胡晓武,邵群,林云飞,等.综合预防措施对血液肿瘤病人化疗后感染情况的影响[J].安徽医药,2023,27(6):1220-1223. |
| 综合预防措施对血液肿瘤病人化疗后感染情况的影响 |
| Effect of comprehensive preventive measures on postchemotherapy infections in hematological tumor patients |
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| DOI：10.3969/j.issn.1009-6469.2023.06.037 |
| 中文关键词: 交叉感染 血液肿瘤 预防措施 住院费用 |
| 英文关键词: Cross infection Hematologic malignancy Preventive measures Hospital costs |
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| 摘要点击次数: 704 |
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| 中文摘要: |
| 目的观察并分析血液肿瘤病人化疗后医院感染的特点，并探讨综合性预防措施控制医院感染的效果。方法调查 2018年 10月至 2021年 9月安徽理工大学第一附属医院血液内科住院且接受化疗后的所有血液肿瘤病人，共纳入 152例进行研究。回顾性分析他们的性别、年龄、基础疾病、疾病种类、住院时间、是否发生医院感染、是否采取本研究设计的预防感染的综合措施等。将使用预防措施的病人定义为综合预防措施组(综合组， 82例)，未使用的病人定义为非综合预防措施组(非综合组， 70例)比较两组医院感染的发病率、抗生素使用情况、住院日及住院费用等指标的差异。结果综合组和非综合组在性别、年龄、疾病，种类等方面差异无统计学意义( P>0.05)。综合组医院感染的发病率为 21.95%，显著低于非综合组的 47.14%(P=0.002)；综合组的住院日为( 15.90±7.47)d，低于非综合组的( 18.90±9.33)d(P=0.029)；综合组的住院费用( 24 520.99±14 447.73)元，低于非综合组的( 27 695.07±20 085.61)元( P=0.030)均差异有统计学意义。单因素分析显示年龄 >65岁、髓系肿瘤、合并糖尿病、未采取综合措施、初次化疗、住院时间 >20 d是发生，医院感染的危险因素( P<0.05)。其中初次化疗的病人发生医院感染的比例 68.63%明显高于维持性化疗的病人的 31.37%(P=0.002)髓系肿瘤病人化疗后发生医院感染的比例 64.71%明显高于非髓系肿瘤的 35.29%(P=0.010)。多元非条件 logistic多因素分析显，示年龄 >65岁、髓系肿瘤、住院时间 ≥20 d、未采取综合预防措施是医院感染发生的独立危险因素( P<0.05)。其中未采取预防措施比采取预防措施危险性增加 2.61倍。结论血液肿瘤病人化疗后发生的医院感染有别于其他疾病病人，不同类型的血液肿瘤也有所区别，应该特别重视髓系肿瘤的医院 |
| 英文摘要: |
| Objective To observe and analyze the characteristics of hospital-acquired infections after chemotherapy in hematologictumor patients and to explore the effect of comprehensive preventive measures to control hospital-acquired infections.Methods A total of 152 hematologic tumor patients who were hospitalized in the Department of Hematology of the First Affiliated Anhui University ofScience and Technology and received chemotherapy from October 2018 to September 2021 were investigated and included in the study.A retrospective analysis of their gender, age, underlying disease, type of disease, duration of hospitalization, whether they had hospital-acquired infections, and whether they took the comprehensive measures for infection prevention designed for this study was performed.The patients who used prophylaxis were defined as the combined prophylaxis group (combined group, 82 cases), and those who did notuse prophylaxis were defined as the noncombined prophylaxis group (noncombined group, 70 cases). The differences in the incidence ofhospital-acquired infections, antibiotic use, hospital days and hospital costs between the two groups were compared. Results There was no statistically significant difference between the comprehensive and noncomprehensive groups in terms of gender, age, and type ofdisease (P>0.05). The incidence of hospital infection in the comprehensive group was 21.95%, which was significantly lower than thatin the non-comprehensive group (47.14%) (P=0.002). The hospital stay in the combined group was (15.90±7.47) d, which was lowerthan (18.90±9.33) d in the noncombined group (P=0.029); the cost of hospitalization in the combined group (24,520.99±14,447.73) yuan was lower than (27,695.07±20,085.61) yuan in the noncombined group (P=0.030), all of which were statistically significant differences. Univariate analysis showed that age > 65 years, myeloid tumors, combined diabetes, failure to take comprehensive preventive measures, initial chemotherapy, and hospital stay > 20 days were risk factors for the development of hospital-acquired infection (P<0.05).The rate of hospital infection was significantly higher in patients with initial chemotherapy (68.63%) than in patients with maintenancechemotherapy (31.37%) (P=0.002), and the rate of hospital infection after chemotherapy was significantly higher in patients with myeloid tumors (64.71%) than those with nonmyeloid tumors (35.29%) (P=0.010). Multivariate unconditional logistic analysis showed thatage > 65 years, myeloid tumors, hospital stay ≥ 20 d, and failure to take comprehensive precautions were independent risk factors for taking prophylaxis.Conclusions Hospital-acquired infections occurring after chemotherapy in hematologic tumor patients are different from those in patients with other diseases, and different types of hematologic tumors also differ, so special attention should be givento the prevention of hospital-acquired infections in myeloid tumors. Comprehensive preventive measures can reduce the incidence of postchemotherapy infections. |
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