目的 分析小儿急性白血病化 疗后肺部感染的临床特点、影像学表现 及干预效果。方法 研究对象为2016年1 月-2018年7月在本院接受化疗且化疗后 继发肺部感染的60例急性淋巴细胞白血 病患儿。以查阅病历及影像学资料方式 统计患者临床特征、影像学表现及干预 情况。结果 首发症状以发热、咳嗽为主 (60.00%、58.33%)，主要临床症状亦以咳 嗽、发热占比更高(68.33%、78.33%)； 41.67%的肺部感染发生于化疗31-45d， 33.33%发生于46-60d；66.67%患儿中性 粒细胞绝对值<0.5×109 /L，36.00%患儿 淋巴细胞绝对值<0.5×109 /L，73.33%患 儿白细胞绝对值<5×109 /L；感染病因 以细菌占比最高(41.67%)，其次为真菌 (36.67)。60例患儿中，磨玻璃影征象占 比最高(48.33%)，其次为磨玻璃影与实变 影并存征象(45.00%)，实变影征象占比最 低(1.67%)；且致病菌为细菌、病毒、混 合感染患儿的CT征象均以磨玻璃影占比最 高，而真菌、支原体为致病菌患儿CT征象 则分别以磨玻璃影与实变影并存、网格或 索条影占比最高(63.64%、100.00%)，干 预总有效率则为86.66%(52/60)。结论 儿 急性白血病化疗后肺部感染的临床特征、 影像学表现均有一定特征性表达，或可为 该类患者的临床防治提供参考意见。

Objective To analyze the clinical features, imaging findings and intervention effects of pulmonary infection in children with acute leukemia after chemotherapy. Methods The study objects were from the 60 children with acute lymphoblastic leukemia who underwent chemotherapy in the hospital and then were with secondary pulmonary infection during the period from January 2016 to July 2018. The clinical features, imaging findings and intervention conditions were statistically analyzed by reviewing medical records and imaging data. Results The first symptoms were mainly on fever and cough (60.00%, 58.33%). The proportions of main clinical symptoms such as cough and fever were higher (68.33%, 78.33%). 41.67% of pulmonary infection occurred within 31 to 45d after chemotherapy. 33.33% occurred within 46 to 60d. The absolute value of neutrophil in 66.67% children was less than 0.5×109/L. The absolute value of lymphocyte in 36.00% children was less than 0.5×109/L. The absolute value of white blood cell in 73.33% children was less than 5× 109/L. The proportion of infection caused by bacteria was the highest (41.67%), followed by fungi (36.67). Among the 60 children, the proportion of ground-glass opacity sign was the highest (48.33%), followed by the sign of groundglass opacity and consolidation shadow (45.00%). And the proportion of consolidation shadow sign was the lowest (1.67%). The proportion of ground-glass opacity was the highest in CT signs of children with bacteria, viruses and mixed infections as pathogenic bacterium. The proportions of ground-glass opacity coexistence with consolidation shadow, grid or linear opacities were the highest of children with fungi and mycoplasma as pathogenic bacterium (63.64%, 100.00%). And the total response rate of intervention was 86.66% (52/60). Conclusion There is certain characteristic expression from the clinical features and imaging findings of pulmonary infection in children with acute leukemia after chemotherapy, which can provide reference for the clinical prevention and treatment for such patients.