儿童急性淋巴细胞白血病化疗后合并肺部感染的临床特征

发布时间：2018-06-19 09:15

本文选题：急性淋巴细胞白血病 + 肺部感染　；参考：《中国当代儿科杂志》2017年12期

【摘要】：目的分析化疗后合并肺部感染的急性淋巴细胞白血病(ALL)患儿的临床特征,为ALL合并肺部感染的早期诊断提供依据。方法对115例次化疗后合并肺部感染且行肺部CT的ALL患儿(108例)进行回顾性分析,收集患者一般临床资料及肺部螺旋CT结果,探究肺部感染发生的危险因素,以及病原体与肺部CT的影像学特点。结果儿童ALL化疗后的肺部感染77.4%发生于诱导缓解阶段,多发生于化疗后的31~60?d,以粒缺患儿所占比例(67.0%)最高。病原学拟诊或确诊的41例肺部感染患儿以细菌感染(36%)与真菌感染(41%)的发生率较高。细菌或真菌感染所致肺部病变CT表现的差异无统计学意义(P0.05)。结论 ALL患儿在化疗诱导缓解阶段,尤其是粒细胞缺乏时肺部感染发生率高。细菌和/或真菌是主要病原体,难以根据肺部影像学改变明确肺部感染的性质。
[Abstract]:Objective to analyze the clinical features of children with acute lymphoblastic leukemia (ALL) complicated with pulmonary infection after chemotherapy, and to provide evidence for early diagnosis of all with pulmonary infection. Methods the clinical data of 115 cases of all children with pulmonary infection and lung CT were analyzed retrospectively. The clinical data and the results of spiral CT were collected to explore the risk factors of pulmonary infection. And the imaging features of pathogen and lung CT. Results 77.4% of all children's pulmonary infection occurred in the stage of induction and remission, most of them occurred at 31 ~ 60 days after chemotherapy, and the proportion of children with grain deficiency was 67.0%. The incidence of bacterial infection (36%) and fungal infection (41%) was higher in 41 cases of pulmonary infection diagnosed or diagnosed by etiology. There was no significant difference in CT findings of pulmonary lesions caused by bacterial or fungal infection (P 0.05). Conclusion the incidence of pulmonary infection in children with all is high in the remission stage induced by chemotherapy, especially in granulocyte deficiency. Bacteria and / or fungi are the main pathogens, it is difficult to determine the nature of pulmonary infection based on lung imaging changes.
【作者单位】：南方医科大学南方医院;
【基金】：国家自然科学基金(81270632)
【分类号】：R725.6;R733.71

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