Abstract:

To discuss the relation between early manifestations and severity of chemotherapy-related infection in children with tumor. Methods　The manifestations of infection during or after chemotherapy in 346 cases of 136 children with tumor were analyzed，and the differences in early manifestations between severe and mild infection were compared. Results　One hundred and thirty-three cases had severe infection，and 213 cases had mild infection. The incidences of chill，ague，fatigue，poor peripheral circulation and neutropenia in severe infection were significantly higher than those in mild infection. The highest temperature and the level of CRP at 6 to 12 hours during fever in severe infection were significantly higher than those in mild infection ； on the other hand，the probability to be severe infection in children with intensive chemotherapy，chill，ague，fatigue，poor peripheral circulation，absolute neutrophil count （ANC）≤0.5×109/L，CRP ≥ 40 mg/L，temperature ≥ 39.5 ℃ was higher than that in those without these manifestations （P < 0.05）. Conclusions　Children with intensive chemotherapy，chill，ague，fatigue，poor peripheral circulation，absolute neutrophil count （ANC） ≤ 0.5×109/L，CRP ≥ 40 mg/L， temperature ≥ 39.5 ℃ are more frequently to have severe infection.

Key words: infection, tumor, children, severe infection

摘要：

探讨肿瘤患儿化疗相关感染早期临床表现与感染严重程度的关系，寻找早期提示重症感染的线索。方法　2005年10月至2009年1月在中山大学附属第一医院儿科化疗并发生化疗相关感染的肿瘤患儿136例，共发生感染346例次，比较重症感染与轻症感染患儿早期临床表现的差异。结果　重症感染133例次，轻症感染213例次。重症感染患儿早期伴畏寒、寒战、精神欠佳、末梢循环不良、粒细胞缺乏的患儿明显多于轻症感染患儿，且热峰及发热6～12 h C-反应蛋白（CRP）值均较轻症感染患儿高；接受强化疗患儿中，感染早期伴畏寒、寒战、精神欠佳、末梢循环不良、中性粒细胞计数≤0.5×109/L 、CRP ≥ 40 mg/L、热峰 ≥39.5℃的患儿发生重症感染的机会大于无上述表现者，差异有统计学意义（P < 0.05）。结论　接受强化疗及感染早期伴畏寒、寒战、精神欠佳、末梢循环不良、中性粒细胞计数0.5×109/L 、CRP ≥ 40 mg/L、热峰 ≥ 39.5℃患儿易发展为重症感染。

关键词: 感染, 肿瘤, 儿童, 重症感染