探討造血幹細胞移植之感染防護

To Explore Infection Prevention of Hematopoitic Stem Cell Transplantation

近年來全球及台灣造血幹細胞移植治療呈增加趨勢，移植前高劑量化學或放射線治療，造成全血球數目及免疫力下降，移植後感染預防及控制與造血幹細胞移植病患存活率及成功率息息相關，預防及控制感染因而成為醫護團隊努力的重點。美國的手部清潔指引指出，以酒精摩擦的手清潔較肥皂洗手好；當口罩因呼吸或外在濺濕因素變濕，失去保護功能時就應更換。戴手套不能取代洗手，醫療人員照護不同病患或執行不同醫療程序時，應更換手套及隔離衣。良好的口腔照護亦是阻斷感染的重要途徑。本文希冀提供醫療人員簡要的預防感染措施及概念，以提升骨髓移植病患在移植後的照護品質及成功率。

Increasingly, hematopoietic stem cell transplantation (HSCT) is adopted to treat haemato-oncological disease, malignant disease, or a genetic disease. Complete cell count and immune system of HSCT receipts are decreased due to side-effects of high-dose chemotherapy and radiotherapy. Better infection prevention and control after transplantation can improve outcome of HSCT and reduce mortality. Thus, infection control and prevention become the major concern for health professionals. According to the hand-hygiene guidelines in American, using an alcohol-based hand rub is the preferred hand hygiene than hand washing with soap. Mask should be changed whenever it becomes wet or dirty because of breathing or outside splatter. Most importantly, wearing gloves dose not replace hand washing and hand hygiene. The health professionals also need to change their gloves and gowns between patients and between procedures on the same patients. Mouth care should be given enough attention to prevent any possible infection. This article provides health professionals a simple prevention concept and strategies in order to enhance quality of care for HSCT patients.