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当今处于耐第三代头孢菌素的产超广谱酶和产诱导酶菌株逐渐增多、肿瘤化疗不断强化和脏器移植日趋频繁的时代,尤其是急性白血病强烈化疗以骨髓重度抑制为目标,骨髓移植预处理采取扫荡性化疗或/和总体照射,宿主的造血细胞和免疫活性细胞遭到严重毁损,继发于中性粒细胞缺乏(粒缺)和宿主免疫机能减损的严重或致死性细菌或/和霉菌感染构成了新的挑战.现就发热性粒缺继发感染的特征及其治疗作如下综述.1 宿主的特征宿主粒缺和免疫机能减损是感染增加的重要因素.某些基础疾患及直接病因可造成宿主机体免疫机能减损.基础疾患包括:(1)恶性肿瘤:白血病、恶性淋巴瘤、多发性骨髓瘤、实体瘤等;(2)造血系统疾患:再生障碍性贫血;(3)免疫机能缺陷:先天或获得性(AIDS);(4)胶原系统疾病;(5)各种代谢疾患:糖尿病、尿毒症及肝机能不全;(6)营养不良.直接病因包括:(1)细胞毒化疗药物及免疫抑制剂;
In the era of increasing production of ultra-broad-spectrum and production-inducing strains that are resistant to the third generation cephalosporins, the continuous intensification of tumor chemotherapy, and the increasing frequency of organ transplantation, especially the acute leukemia intensive chemotherapy, which targets bone marrow suppression. The transplant pretreatment is followed by sweeping chemotherapy or/and total irradiation. The host’s hematopoietic cells and immunocompetent cells are severely damaged, secondary to severe or lethal bacteria that are deficient in neutrophils (grain deficiencies) and host immune compromise. / and fungal infection constitute a new challenge. The characteristics and treatment of fever secondary granuloma secondary infection are summarized as follows. 1 Host characteristics Lack of host deficiencies and impaired immune function are important factors for increased infection. Some underlying disorders And direct cause can cause host immune function impairment. Basic diseases include: (1) malignant tumors: leukemia, malignant lymphoma, multiple myeloma, solid tumor, etc.; (2) hematopoietic system disorders: aplastic anemia; (3 ) Immune function defects: congenital or acquired (AIDS); (4) collagen system diseases; (5) various metabolic diseases: diabetes, uremia, and liver insufficiency; (6) malnutrition. direct cause Including: (1) Cytotoxic chemotherapy drugs and immunosuppressants;