Mô hình biến chứng nhiễm khuẩn ở bệnh nhi lơ xê mi cấp dòng tủy điều trị phác đồ MASPORE 2006 tại Viện Huyết học - Truyền máu Trung ương=Patterns of infectious complications in pediatric patients with acute myeloid leukemia treated MASPORE regimen at the National Institute of Hematology and Blood Transfusion

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Tác giả: Thị Vân Nga Bùi, Thị Hồng Hoàng, Lan Mai, Hà Thanh Nguyễn, Hồng Sơn Nguyễn, Thị Hương Giang Nguyễn, Quỳnh Mai Trần, Thu Thủy Trần

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.177-184

Bộ sưu tập: Metadata

ID: 478232

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Mô tả mô hình biến chứng nhiễm khuẩn ở bệnh nhi LXM cấp dòng tủy điều trị bằng phác đồ Maspore tại Viện Huyết học – Truyền máu Trung ương, giai đoạn từ 1/2019- 12/2022. Đối tượng: 148 bệnh nhi mặc Lơ xê mi cấp dòng tủy, điều trị bằng phác đồ Maspore 2006 tại Viện Huyết học- Truyền máu Trung ương từ tháng 1/2019 - tháng 12/2022. Phương pháp nghiên cứu: Mô tả cắt ngang. Kết quả: Tỷ lệ nam/nữ mắc LXM cấp dòng tủy khoảng 1,2/1 với độ tuổi trung bình là 8,4 tuổi. Khi điều trị hóa chất, hầu hết bệnh nhân (97,6%) đều có biến chứng nhiễm khuẩn với các mức độ khác nhau, 19,2% đợt điều trị gặp biến chứng nặng và nghiêm trọng. Tỷ lệ nhiễm khuẩn huyết trong các đợt điều trị khá cao, gặp nhiều ở đợt 1 với 14,1%, đợt 4 với 23,5% và đợt 5 là 20,2%
tỷ lệ cấy máu dương tính là 8,2%. Vi khuẩn gram âm chiếm tỷ lệ cao nhất 56,4%, vi khuẩn gram dương và nấm có tỷ lệ lần lượt là 22,2% và 21,4%. Trong các tác nhân nhiễm khuẩn huyết, trực khuẩn mủ xanh, E.coli, Klebsiella, tụ cầu vàng và nấm Candida là những tác nhân gây nhiễm khuẩn huyết phổ biến chiếm trên 60% tổng số trường hợp
trong đó, trực khuẩn mủ xanh và nấm Candida gây NKH chiếm tỷ lệ cao nhất lần lượt là 19,8% và 18,3%. Kết luận: Hầu hết các đợt điều trị đều có biến chứng nhiễm khuẩn với các mức độ khác nhau, 19,2% đợt điều trị gặp biến chứng nặng và nghiêm trọng. Tỷ lệ nhiễm khuẩn huyết ở đợt 1 là 14,1%, đợt 4 -23,5% và đợt 5 - 20,2%
tỷ lệ cấy máu dương tính là 8,2%
vi khuẩn gram âm là tác nhân gây bệnh chủ yếu (56,4%).To describe the model of infectious complications in pediatric patients with acute myeloid leukemia treated with the Maspore regimen at the National Institute of Hematology and Blood Transfusion, from January 2019 to December 2022. Subjects: 148 pediatric patients with acute myeloid leukemia, treated with the Maspore 2006 regimen at the National Institute of Hematology and Blood Transfusion from January 2019 to December 2022. Research method: Cross-sectional. Results: The male/female ratio of acute myeloid leukemia is about 1.2/1 with an average age of 8.4 years old. During chemotherapy, most patients (97.6%) had infectious complications of varying degrees, 19.2% of treatment courses had severe and critical complications. The rate of bacteremia in treatment courses was quite high, occurring in the first course with 14.1%, the fourth course with 23.5% and the fifth course with 20.2%
the rate of positive blood cultures was 8.2%. Gram-negative bacteria accounted for the highest rate of 56.4%, gram-positive bacteria and fungi had rates of 22.2% and 21.4%, respectively. Among the agents of bacteremia, Pseudomonas aeruginosa, E.coli, Klebsiella, Staphylococcus aureus and Candida were the common agents causing bacteremia, accounting for over 60% of the total number of cases. Of which, Pseudomonas aeruginosa and Candida caused NK with the highest rates of 19.8% and 18.3%, respectively. Conclusion: Most treatment courses had infectious complications of varying degrees, 19.2% of treatment courses had severe and critical complications. The rate of sepsis in the first course was 14.1%, in the fourth course - 23.5% and in the fifth course -20.2%
the rate of positive blood cultures was 8.2%
gram-negative bacteria were the main causative agents (56.4%).

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