急性白血病伴粒细胞缺乏患者预防性应用抗生素的疗效及安全性分析.doc

急性白血病伴粒细胞缺乏患者预防性应用抗生素的疗效及安全性分析 葛仁英 徐旭燕 咸宁市中心医院 湖北科技学院附属第一医院，湖北咸宁，437100 摘要：目的：探讨急性白血病伴粒细胞缺乏患者采用预防性应用抗生素的疗效及安全性。方法：收集我科38例成人急性白血病伴粒细胞缺乏患者感染发热事件的发生率，其中预防组（n = 18）在粒缺时给予万古霉素联合头孢吡肟（2g，q12h）或单用哌拉西林/他唑巴坦（4.5g，q12h）预防细菌感染。对照组患者（n = 20）没有接受预防性抗生素治疗。结果：预防组（59个治疗周期）发热事件频率低于对照组（0.4，0.9; p 0.001），粒细胞缺乏与发热间隔较长（6.4天，3.8天; p = 0.007），住院时间较短（21.5天，28.5天; p 0.001），肺部感染率较低（38.8％，80.0％; p 0.001）。一名应用万古霉素的患者出现皮疹，3名应用哌拉西林/他唑巴坦的患者出现腹泻，抗生素停药后，这些副作用消退。结论：在急性白血病患者中伴粒细胞缺乏症预防性使用抗生素可有效降低感染性发热的发生率，缩短住院时间。 关键词：急性白血病 粒细胞缺乏 抗生素 疗效 安全 Gerenying Xuxuyan Department of Respiratory and Hematology Medicine, Xianning Central Hospital/the First Affiliated Hospital of Hubei University of science and technology,Xianning Hubei,437100 Evaluation of the efficacy and safety of antibiotic prophylaxis in patients with acute leukemia with gianulocyte deficiency. ABSTRACT: Objective To explore Evaluation of the efficacy and safety of antibiotic prophylaxis in patients with acute leukemia with gianulocyte deficiency Methods :use prospectively,studied the incidence of febrile episodes in 38adult patients with acute leukemia with granulocyte deficiency,the prevention and treatment group (n =18)was treated with vancomycin/ceftizocime(1g,q12h/2g,q12h) or piperacillin/tazobutctan (4.5g,q12h)in the treatment of.And the patients (n=20)in the control group were not treated with antibiotics. Results the incidence of fever events in the prevention group (59treatment cycles)was lower than that in the control group (0.4,0.9;p0.001),and there was a short interval between granulated deficiency and fever (6.4days,6.8days;p=0.007),shorter hospitalization time （21.5 day,28.5days;p0.001) and lower pulmonary infeetion rate (38.8%,80.0%;p0.001).One of the patient who received vancomycin had a rash,and diarrhea occurred in three patient treated with piperacillin /tazobactam,and these sid effects subside after antibiotic withdrawal. Conclusion:In acute leukemia patients.Prophylactic use of antibiotics for chemotherapy-induced anemia