摘要
恶性血液病患者出现严重的肺部并发症,预后较差,尤其是在骨髓移植(BMT)后。我们研究了呼吸道重症监护室(RICU)收治的相应人群的病因,不同诊断工具的产量,以及结局和预后因素。总体而言,在10年内接受治疗的89例血液系统恶性肿瘤和肺部并发症患者被纳入研究。潜在恶性肿瘤主要为急性白血病和慢性髓系白血病(66/ 89,74%)。89例患者中52例(58%)为骨髓接受者。在61/89(69%)的病例中可以得到病因诊断。病因为感染性37例(42%),非感染性24例(27%)。血培养和支气管肺泡灌洗液细胞学检查是最高的诊断工具(阳性结果分别为13/43(30%)和13/45(29%))。在43%的感染性病因病例和60%的非感染性病因病例中,尸检结果与一生中获得的结果一致。移植受者的总死亡率为70/89(79%),47/52(90%)。 The requirement of mechanical ventilation, BMT, and an interval <90 days of BMT prior to ICU admission were independent adverse prognostic factors. The outcome in this patient population was uniformly poor. It was worst in bone marrow recipients developing pulmonary complications <90 days after transplantation and requiring mechanical ventilation. Decisions about intensive care unit admission and mech-anical ventilation should seriously consider the dismal prognosis of these patients.