Investigation And Analysis Of The Clinical Characteristics And Influencing Factors Of Hematologic Malignancies Complicated By Hospital-acquired Pneumonia

Object Investigation of hematologic malignancies are complicated by hospitalacquired pneumonia in clinical presentation, pathogenic characteristics, influencing factors,treatment and prognosis which provide the basis for the prevention and treatment.Methods Retrospective analysis of the inpatient data with hematologic malignanciesare complicated by hospital acquired pneumonia in Ningxia Medical University GeneralHospital Department of Hematology, July2003~July2011.Results1. Cases times the incidence rate of hematologic malignancies complicated byhospital acquired pneumonia is11.30%，with multiple myeloma complicated by hospitalacquired pneumonia is most common; The elderly is the infection of high risk population.2.Most patients have fever, cough, half of the performance of a dry cough; some patientsaccompanied by chills, chest tightness, shortness of breath and chest pain; mostly are bilaterallesions, signs and imaging exudative change, signs of consolidation are relatively rare; insome patients combined metastasizing septicemia, a small number of patients with havesepticemia, septic shock and other parts of the infection. Hematologic malignanciescomplicated with hospital acquired pneumonia is a serious disease.3. Sputum culture resultsof Gram-negative bacteria (G~-) accounted for45.16%, Gram-positive bacteria (G~+) accountedfor29.03%, fungi accounted for25.80%.4. Predisposing factors are related to primary diseasetypes, age, granulocyte levels, chemotherapy, immunosuppressive therapy and length ofhospital stay and so on.5. In120cases with hematologic malignancies complicated byhospital acquired pneumonia in hospital,119cases are the anti-infective therapy, which cured 66cases (55.46%), effective in23cases (19.33%), the progress of16cases (13.45%), invalidin14cases (11.76%), the treatment efficiency is74.79%(89/119),it seems lower than theefficiency of common nosocomial pulmonary infection treatment.Conclusion1. Hematologic malignancies complicated with hospital acquiredpneumonia occurs at a higher rate, serious threat to patient treatment and survival.2. Patientswith the disease are mostly based on typical clinical manifestations and imaging to diagnosis;some patients lack of typical clinical manifestations, depend on early imaging diagnosis; aminority of patients likely to progress to metastasizing septicemia, septicemia and septicshock;3. Gram-negative bacteria (G~-) infection is in the first place;4. The primary diseasetypes, old age, neutropenia, chemotherapy, immunosuppressive therapy, and long hospitalstay are the important factors to cause hospital-acquired pneumonia;5. The anti-infectivetreatment of hematologic malignancies complicated by hospital-acquired pneumonia isdifficult, which needs to pay more attention to the rational use of antimicrobial drugs.