發(fā)布時(shí)間：2018-06-19 09:15

  本文選題：急性淋巴細(xì)胞白血病 + 肺部感染��； 參考：《中國(guó)當(dāng)代兒科雜志》2017年12期

【摘要】：目的分析化療后合并肺部感染的急性淋巴細(xì)胞白血病(ALL)患兒的臨床特征,為ALL合并肺部感染的早期診斷提供依據(jù)。方法對(duì)115例次化療后合并肺部感染且行肺部CT的ALL患兒(108例)進(jìn)行回顧性分析,收集患者一般臨床資料及肺部螺旋CT結(jié)果,探究肺部感染發(fā)生的危險(xiǎn)因素,以及病原體與肺部CT的影像學(xué)特點(diǎn)。結(jié)果兒童ALL化療后的肺部感染77.4%發(fā)生于誘導(dǎo)緩解階段,多發(fā)生于化療后的31~60?d,以粒缺患兒所占比例(67.0%)最高。病原學(xué)擬診或確診的41例肺部感染患兒以細(xì)菌感染(36%)與真菌感染(41%)的發(fā)生率較高。細(xì)菌或真菌感染所致肺部病變CT表現(xiàn)的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 ALL患兒在化療誘導(dǎo)緩解階段,尤其是粒細(xì)胞缺乏時(shí)肺部感染發(fā)生率高。細(xì)菌和/或真菌是主要病原體,難以根據(jù)肺部影像學(xué)改變明確肺部感染的性質(zhì)。
[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.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金(81270632)
【分類(lèi)號(hào)】：R725.6;R733.71

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