【摘要】 目的:探讨造血干细胞移植(HSCT)后感染的发生率、病原菌分布情况及经验性治疗方法。方法:对50例患者HSCT后感染及相应治疗的临床资料进行综合分析。结果:50例患者HSCT后,在ANC≥0.5×109/L前出现感染的有44例(88%),在ANC≥2.0×109/L前出现感染的有14例(28%)。采用我院选用的经验性治疗方案,即一线为碳青霉烯类单药或加用氨基糖甙类;二线选三代头孢菌素加用万古霉素;三线选了另一种碳青霉烯类加两性霉素B/伊曲康唑治疗。最终仅有3例患者因同时并发有重度移植物抗宿主病或植入失败导致的特殊感染而死亡。结论:我院采用的抗感染治疗的三线使用方案对于治疗HSCT后粒细胞缺乏/减少状态下发热患者是相当有效的。更多还原

【Abstract】 Objective:To explore the incidence,distribution of pathogen and empirical treatment of infection after hematopoietic stem cell transplantation(HSCT).Method:The infection and the corresponding therapy in 50 patients who received HSCT was analyzed.Result:Among 50 patients who received HSCT,44(88%) cases developed fever before ANC ≥ 0.5 ×109/L.14(28%)cases developed fever before ANC ≥2.0×109/L.The following empirical antibiotic therapy in our hospital was adopted.Some of the patients were administered with single carbapenem or combined with amino glycoside as the first line.The second line was administering with agent of the third generation cephalosporin combined with vancomycin.The third scheme was administering another kind of carbapenem combined with amphotericin B.There were only three patients who died of special infection complicating severe GVHD or graft failure.Conclusion:During the period of agranulocytosis and granulocytopenia after HSCT,the anti-infection treatment of the three lines which is adopted in our hospital is very effective for patients with infection.更多还原