异基因造血干细胞移植病人医院感染的影响因素及生存分析OA

Objective:To explore the influencing factors and survival analysis of hospital infection during the period from pre-treatment to hematopoietic reconstitution in patients undergoing allogeneic hematopoietic stem cell transplantation,and to provide reference basis for nosocomial infection and continuous care of hematopoietic stem cell transplant patients.Methods:Retrospective cohort study design was used to collect clinical data and interventable nursing variables in the occurrence and development of infection from 57 patients with allogeneic hematopoietic stem cell transplantation at the Second Hospital of Shanxi Medical University from January 2017 to May 2020.The main influencing factors of infection were analyzed through multivariate Logistic regression.Survival analysis was carried for follow up data of patients until July 1,2023.Results:During the transplantation period,9 patients did not experience hospital infections,while 48 patients developed hospital infections.Before pre-treatment,there was no statistically significant difference in baseline data between the infected and uninfected groups.As the transplantation protocol progressed,the nutritional and psychological status of the two groups of patients changed,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that nutritional status and psychological status were influencing factors for hospital infection in hematopoietic stem cell transplant patients.Follow up until July 1,2023,24 cases died and 33 cases survived,the longest survival time is 79 months.Despite the fact that continuous care outside the hospital has targeted nutritional and psychological interventions,the survival rate of patients with good nutritional and psychological status was still higher than that of the control group.Conclusions:Nutritional status and psychological status are intervenable nursing factors in hospital infection of patients undergoing allogeneic hematopoietic stem cell transplantation.They are closely related to infection and survival of patients.Emphasizing patients' nutritional status and improving their psychological status not only helps to reduce the risk of hospital infection,but also is one of the factors in improving the quality of continuous nursing outcomes.