目的:分析急性白血病(acute leukemia,AL)儿童化疗期间医院感染的相关因素及其预测效能。方法:回顾性选取 2020 年 6 月—2022 年 6 月南京医科大学附属淮安第一医院收治的 152 例AL化疗患儿。收集所有患儿一般资料,统计所有患儿医院感染情况。分析医院感染情况。比较两组一般资料。分析AL儿童化疗期间医院感染影响因素。分析独立影响因素对AL儿童化疗期间并发医院感染的预测价值。结果:152 例AL化疗患儿并发医院感染 46 例,发生率为 30。26%(46/152)。并发医院感染组住院时间长于无并发医院感染组,有皮肤黏膜损害、应用抗生素、诱导缓解期占比均高于无医院感染组,中性粒细胞计数、白蛋白水平均低于无医院感染组,差异有统计学意义(P<0。05)。住院时间、存在皮肤黏膜损害、中性粒细胞计数、白蛋白均为AL化疗患儿并发医院感染的独立影响因素(P<0。05)。住院时间、皮肤黏膜损害、中性粒细胞计数、白蛋白均对预测AL化疗患儿并发医院感染具有一定价值,曲线下面积(area under the curve,AUC)分别为 0。733、0。683、0。815、0。759。结论:AL儿童化疗期间医院感染的相关因素包括住院时间、皮肤黏膜损害、中性粒细胞计数及白蛋白,且上述因素均具有良好预测价值。
Correlation Factors and Predictive Efficacy of Nosocomial Infection in Children with Acute Leukemia during Chemotherapy
Objective:To analyze the correlation factors and predictive efficacy of nosocomial infection in children with acute leukemia during chemotherapy.Method:A total of 152 children with AL chemotherapy treated in Huai'an First Hospital Affiliated to Nanjing Medical University from June 2020 to June 2022 were retrospectively selected.The general data of all children were collected,and the nosocomial infection of all children was analyzed.The situation of hospital infection was analyzed.The general data was compared between the two groups.The influencing factors of nosocomial infection in AL children during chemotherapy was analyzed.The predictive value of independent influencing factors for nosocomial infection in AL children during chemotherapy was analyzed.Result:Among 152 children with AL chemotherapy,46 cases were complicated with nosocomial infection,with the incidence of 30.26%(46/152).The hospital stay of the group complicated with nosocomial infection was longer than that of the group without complicated with nosocomial infection,the proportions of skin mucosal damage,antibiotic application and induced remission stage were higher than those of the group without complicated with nosocomial infection,and the neutrophil count and albumin level were lower than those of the group without complicated with nosocomial infection,the differences were statistically significant(P<0.05).Length of stay,presence of skin mucosa damage,neutrophil count and albumin were all independent influencing factors of nosocomial infection in children with AL chemotherapy(P<0.05).Length of stay,skin mucosa damage,neutrophil count and albumin were all valuable in predicting nosocomial infection in children with AL chemotherapy,and the area under the curve(AUC)were 0.733,0.683,0.815 and 0.759 respectively.Conclusion:The factors associated with nosocomial infection in AL children during chemotherapy included length of stay,skin mucosal damage,neutrophil count and albumin,all of which had good predictive value.