目的 探讨急性白血病患儿化疗后中性粒细胞缺乏伴发热（febrile neutropenia，FN）的现状及影响因素，为临床医护人员早期预防、识别及干预提供依据。方法 2022年1-12月，采用便利抽样法选取在上海某三级甲等儿童医院进行化疗的801例白血病患儿为研究对象，采集个人史、疾病史、治疗史与既往史等资料，使用Logistic回归分析筛选急性白血病患儿FN的危险因素，并通过接受者操作特性（receiver operating characteristic，ROC）曲线检验预测效果。结果 急性白血病患儿FN发生率为33.46%。不同个人史、疾病史、治疗史以及既往史的急性白血病患儿在是否发生FN上的差异均有统计学意义（均P＜0.05）。Logistic回归分析显示，年龄、第5天口腔黏膜完整性受损、疾病复发、初次化疗、使用阿糖胞苷、第5天中性粒细胞缺乏是急性白血病患儿发生FN的独立影响因素,ROC曲线下面积为0.884。 结论 急性白血病患儿FN发生率较高，应从初诊开始重视感染防治，尤其是复发、使用阿糖胞苷、年龄小、早期中性粒细胞缺乏的患儿，并加强对口腔黏膜炎、血常规、生命体征等的评估，积极防治口腔黏膜炎和骨髓抑制。

Objective To explore status quo of febrile neutropenia(FN) in children with acute leukemia after chemotherapy and its influencing factors,and to provide reference for early prevention,identification and intervention of clinical staff.Methods A total of 801 pediatric patients with acute leukemia treated with chemotherapy in the Department of Pediatric Hematology in a tertiary A pediatric hospital from January to December 2022 were selected by the convience sampling method.The demographic,disease-related,treatment-related data were collected.Logistic regression analysis was used to screen out the risk factors of FN,and receiver operating characteristic（ROC） cure was used to assess the resulting equation.Results The incidence of FN in children with acute leukemia was 33.46%.There were significant differences in the occurrence of FN among children with acute leukemia with different personal history,disease history,treatment history,and past history (all P＜0.05).Logistic regression analysis showed that age,oral mucosal integrity damage on the 5th day,disease recurrence,primary chemotherapy,use of cytarabine,and neutropenia on the 5th day were independent influencing factors for FN in children with acute leukemia,and the area under the ROC curve was 0.884.Conclusion The incidence of FN in pediatric patients with acute leukemia is relatively high.Prevention of FN should be emphasized from the first-time chemotherapy,especially in pediatric patients with recurrence,young age,and early neutropenia.At the same time,nurses should pay attention to assessment of oral mucositis,blood routine test,and vital signs,so as to actively prevent and treat oral mucositis and bone marrow suppression.

R473.55;R473.72

上海交通大学医学院护理学科人才队伍建设项目（SJTUHLXK2022）；上海市教委护理高原学科项目（hlgy1805kyx/hlgy1802sjk）；上海市卫生健康委员会科研项目（20214Y0106）；上海申康医院发展中心临床三年行动计划资助（SHDC2023CRS010）