固体腫瘍切除を受けた小児腫瘍患者の早期の術後の発熱
John Lundstedt1, Emily Vore1, Joseph Brungardt1
1Division of Pediatric General and Thoracic Surgery. Cincinnati Children's Hospital Medical Center. 3333 Burnet Avenue, Cincinnati, Ohio 45229.
Journal of pediatric surgery
|September 4, 2025
まとめ
術後の発熱は小児がん患者では一般的ですが,本当の感染は稀です. 重要な症状がない限り,最初の2日間は高価な熱検査と広範な検査を避けましょう.
科学分野:
- 小児腫瘍学
- 感染症
- 臨床研究
背景:
- 術後の発熱は,小児腫瘍患者の癌切除後に頻繁に発生する.
- これはしばしば,広範囲で高価な診断に繋がります.
- 感染率と危険因子を特定することは極めて重要です
研究 の 目的:
- 術後の発熱の発生率を決定する.
- 手術後の発熱に伴う危険因子を特定する.
- 本当の感染の発生率と熱検査の有用性を評価する.
主な方法:
- 2018年から2023年までの小児がん患者の遡及的チャートレビュー.
- 化学療法,中枢線,手術の種類,輸血,中性子減少などの変数の分析
- 熱の予測を分析するために使用される一般化された線形混合モデル.
主要な成果:
- 222人の患者の42%が手術後の熱を発症した.
- 予測要因には,輸血,フォリーカテーテル,中性不全,および肉腫組織学が含まれています.
- 発熱した患者の2. 8%だけが治療可能な感染症の原因でした.
結論:
- 術後の発熱は一般的ですが,小児がん患者では感染を示唆する症状は稀です.
- 経験的な抗生物質治療や 広範な作業はしばしば不要です.
- 発熱は症状が顕著な患者に限られます.
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