白血病化疗后粒细胞缺乏伴真菌感染患者抗菌药物的应用研究

发布时间：2018-10-05 15:40

【摘要】：目的探究白血病化疗后粒细胞缺乏伴真菌感染患者抗菌药物的使用情况,为临床制定合理使用抗生素方案提供参考依据。方法回顾性分析淄博市中心医院收治的110例白血病化疗后粒细胞缺乏伴真菌感染患者的一般资料,采用该院自制的白血病化疗后粒细胞缺乏伴真菌感染患者抗菌药物使用情况调查表进行统计,最后根据统计结果进行分析。结果 110例患者中感染部位主要为呼吸道(47.27%)、其次为口腔或消化道(32.73%);通过经验性用药治疗有效率占60.91%;43例经验救治无效后使用补救方案治疗后,有效率达到93.02%,其中1例由于产生不良反应而停止使用,1例由于因感染性休克死亡。经验性用药为单一他唑巴坦/哌拉西林(27.27%)、伊曲康唑(10.00%),而联合用药主要为伊曲康唑+头孢他啶(17.27%),其次为伊曲康唑+万古霉素(9.09%);在经验治疗无效后,使用抗菌药物频率最高的为单一使用氟康唑(23.26%),其次为哌拉西林/他唑巴坦(16.28%),联合用药频率最高的为氟康唑+万古霉素(9.30%),其次为哌拉西林/他唑巴坦+万古霉素(6.98%)。结论该院抗菌药物使用情况合理,针对白血病化疗后粒细胞缺乏伴真菌感染患者应根据患者感染情况,合理选择抗菌药物。
[Abstract]:Objective to investigate the use of antimicrobial agents in leukemic patients with granulocytosis associated with fungal infection after chemotherapy. Methods the general data of 110 leukemia patients with mycosis after chemotherapy were analyzed retrospectively in Zibo Central Hospital. The use of antimicrobial agents in patients with leukaemia and fungal infection after chemotherapy was analyzed by using the self-made questionnaire of antimicrobial agents in our hospital. Results Respiratory tract (47.27%), oral cavity or digestive tract (32.73%) were the main sites of infection in 110 patients. The effective rate was 93.02, of which 1 case was stopped because of adverse reaction and 1 case died of septic shock. The empirical drug was tazobactam / piperacillin (27.27%), itraconazole (10.00%), itraconazole ceftazidime (17.27%), itraconazole vancomycin (9.09%), and itraconazole vancomycin (9.09%). Fluconazole alone (23.26%), piperacillin / tazobactam (16.28%), fluconazole vancomycin (9.30%) and piperacillin / tazobactam vancomycin (6.98%) were the most frequently used antibiotics. Conclusion the use of antimicrobial agents in this hospital is reasonable. The patients with granulocytosis associated with fungal infection after chemotherapy should reasonably select antibiotics according to the infection situation of the patients.
【作者单位】：山东省淄博市中心医院;淄博职业学院;
【分类号】：R519;R733.7

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