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低风险中性粒细胞减少的发热癌症患者的治疗方法。

Approach to treatment of the febrile cancer patient with low-risk neutropenia.

作者信息

Buchanan G R

机构信息

Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas.

出版信息

Hematol Oncol Clin North Am. 1993 Oct;7(5):919-35.

PMID:8226566
Abstract

All cancer patients who develop fever during a period of neutropenia are not at high risk of developing serious infection. Following hospitalization for empiric broad spectrum antibiotic therapy, certain low-risk patients can be identified and safely be discharged "early", prior to recovery of the absolute neutrophil count to 500 cells per mm3. The medical, psychological, and financial benefits of early hospital discharge are immense. Careful examination for serial increases in components of the peripheral blood count herald marrow recovery and help identify the low-risk patient. It may also be possible to identify "low-risk" neutropenic patients upon development of fever in order to explore alternative management strategies (for example, outpatient oral or intravenous antibiotics) rather than routine hospitalization.

摘要

并非所有在中性粒细胞减少期出现发热的癌症患者都有发生严重感染的高风险。在住院接受经验性广谱抗生素治疗后,可以识别出某些低风险患者,并在绝对中性粒细胞计数恢复到每立方毫米500个细胞之前安全地“提前”出院。提前出院在医疗、心理和经济方面的益处是巨大的。仔细检查外周血细胞计数各成分的连续增加情况可预示骨髓恢复,并有助于识别低风险患者。在发热时识别“低风险”中性粒细胞减少患者也有可能,以便探索替代管理策略(例如门诊口服或静脉用抗生素),而非常规住院治疗。

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