摘要
目的 探讨经验治疗和诊断驱动治疗在儿童急性淋巴细胞白血病(ALL)化疗期侵袭性真菌感染(IFD)中的应用效果。方法 回顾性分析2018年2月至2020年12月中山大学孙逸仙纪念医院儿科血液专科106例接受抗真菌治疗的ALL患儿资料,根据治疗方法分为经验组(45例)和诊断组(61例)。比较2组IFD发生率、病死率、发热时间、用药时间、不良反应及转入小儿重症监护室(PICU)情况。结果 诊断组IFD发生率大于经验组,差异有统计学意义(P<0.05)。2组IFD相关病死率、转入PICU情况比较,差异无统计学意义(P>0.05)。2组应用药物之前发热时间、药物应用时间比较,差异有统计学意义(P<0.05)。2组更换药物及不良反应发生情况比较,差异无统计学意义(P>0.05)。结论 经验治疗和诊断驱动治疗是治疗儿童ALL化疗期IFD的有效手段,在临床中要根据患儿具体情况进行选择。
Objective To explore the effect of empirical treatment and diagnostic-driven treatment in invasive fungal infection(IFD)during chemotherapy in children with acute lymphoblastic leukemia(ALL).Methods The data of 106 children with ALL who received antifungal treatment in pediatric hematology department of Sun Yat-Sen Memorial Hospital of Sun Yat-sen University from February 2018 to December 2020 were retrospectively analyzed.According to the treatment methods,they were divided into experience group(45 cases)and diagnosis group(61 cases).The incidence of IFD,mortality,fever time,medication time,adverse reactions and transfer to pediatric intensive care unit(PICU)were compared between the two groups.Results The incidence of IFD in the diagnosis group was higher than that in the experience group,there was significant difference(P<0.05).There were no significant differences in IFD related mortality and transfer to PICU between the two groups(P>0.05).There were significant differences in fever time before drug application and drug application time between the two groups(P<0.05).There were no significant differences in drug replacement and adverse reactions between the two groups(P>0.05).Conclusion Experience therapy and diagnostic-driven therapy are effective methods for the treatment of IFD in children with ALL during chemotherapy,which should be selected according to the specific situation of children in clinic.
作者
张亚停
方建培
王健
李杨
张莉红
周敦华
ZHANG Yating;FANG Jianpei;WANG Jian;LI Yang;ZHANG Lihong;ZHOU Dunhua(Department of Pediatric Hematology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou,Guangdong 510120,China;Department of Pediatrics,Linzhi People's Hospital,Linzhi,Xizang 860000,China)
出处
《现代医药卫生》
2022年第2期215-218,共4页
Journal of Modern Medicine & Health
基金
广东省广州市科学技术厅科技计划项目(201803010032)
西藏自治区自然科学基金项目[XZ2020ZR-ZY57(Z)]。
关键词
儿童
急性淋巴细胞白血病
侵袭性真菌病
经验治疗
诊断驱动治疗
Children
Acute lymphoblastic leukemia
Invasive mycosis
Experience treatment
Diagnostic-driven therapy
