Günther I, Brijmohan-Günther R, Kundt G, Kaben U, Teseler R M
Tokai J Exp Clin Med. 1985 Jun;10(2-3):197-204.
Infectious complications play a major part during the cytostatic treatment of patients suffering from acute leukemia, as well as in bone marrow transplantations. For infection prevention, the method of selective decontamination (SD) of the digestive tract was used. This procedure eliminates the potentially pathogenic aerobic bacteria and yeasts while leaving the anaerobic intestinal microflora unaffected. The protocol of the Gnotobiotic Project Group was used in treating 33 patients with SD and the results were compared with those from a comparable control group consisting of cases selected from files who had been treated without SD in the past. A statistical difference was obtained in favor of the SD patients regarding frequency and severity of infection, time between admission and the first signs of infection, days febrile, and in the additional necessity of antibiotics (p less than 0.01). SD involves in addition to a scheduled intake of tablets, microbiological surveillance, personal hygiene and an intact hemostasis, and optimal results can be obtained given the help of the patients' compliance. SD has won a secured place in treatment tailored upon the pathophysiological concept of infection prevention, even though there are problems remaining, e.g., gram-positive cocci, yeasts and infection of the oropharynx.
感染性并发症在急性白血病患者的细胞毒性治疗期间以及骨髓移植过程中起着重要作用。为预防感染，采用了消化道选择性去污（SD）方法。该程序可消除潜在致病性需氧菌和酵母菌，而不影响肠道厌氧微生物群。使用悉生生物学项目组的方案对33例患者进行SD治疗，并将结果与过去未接受SD治疗的类似对照组（从档案中选取的病例）的结果进行比较。在感染的频率和严重程度、入院至首次感染迹象的时间、发热天数以及抗生素的额外需求方面，SD组患者有统计学差异（p<0.01）。SD除了包括按计划服用片剂外，还涉及微生物监测、个人卫生和完整的止血措施，并且在患者配合的情况下可获得最佳效果。尽管仍存在一些问题，如革兰氏阳性球菌、酵母菌和口咽感染，但SD在基于感染预防病理生理概念的治疗中已占据了稳固地位。
