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Appraisal Quality qf Care in Patients with llematclogic Disease

DuringProtectivelsolaticnandLowResistant

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FACI.ILTY OF SCIENCEMAHIDOL UNIVERSITY

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Bhesis Title Appraisal Quality of Care in patlents

u'ith Hematologic Disease During

Protective lsolation and Low Resistant

Iiiiss Pattama Prasertprasart

Master of Sclence (IVursi:U)

Department of l{ursing

Faculty of Ii,liedicine Ranrathibod.i Hospital

l,{iss Suthapun Jittipun

i'{ovember 15, 1983

Author

Degree

Department

Faculty

L{aj or Ad.visor

Date of thesls Defense

Abstract

The purposes of thls stucly were to 1) evaluate the

quality of protectlve j-solation care that the immuno compromised

patie:rts which were admitted received. z) to foIlow up the

problems of infection encountered by these patients durj:rg

these period and the changes in neutrophils count including

r,'he compllcations through out the study. The subject of

thls study lvere 5 patients lvlth 2 cases of aplastlc anemia

and 3 cases of acute myeloid leukemia vrdro had neutrophils

count less than looo/nn3 and total leukocytes count lessI

t]nan Jooo/mm' and vrere in protective isolation room infemale

medlcar ward" r, male medical ward r and rr, Ramathibodi

Hospital, Ifahidol Uni-versity during periocl of April ]O -Jwre 25 , 1983. The Criterla apprai-saI quality of nursing

care were modified. from the stand.ard of care developedCopyright by Mahidol UniversityCopyright by Mahidol University

by Infectious Control Committee, Ramathibooi Hospital, and

fron llteratures. The, i:rvestigator collected the data daily

from 7.00 Airl. - 12,00 AIi. and 1.00 PIiI. - 6.00 Pl,,i. A11 patients

were studied in protective isolation rooms, for 14 consecutive

days or less if the patlents were belng discharged or were dead.

The quality of nursi-ng care was based on Carter's standard. of

nursi-ng ca"re.

The present study revealed that in the first criterion

whi-ch concerned about preparing and utillzing the protective

isolation room and the second criterion vihich concern5:rg about

the technique and procedur.es d.elivered. to tlie patients were

rated as moderate in only one patient and the others four were

rated as unsatisfaciorlr. B activities of nurslr:g ca.re in the

first criterion and. 10 activities in the second should bc improved.

The third crlterlon which concerncd. about t}:e care of patients'

personal hygiene was rated as good and as moderate in 2 patient

and. the others three were unsatisfact"ory. Nursing care in 6

activitles should be improvecl. Finally the fourth criterion

concernirig about the care of patiunt vl"ith fever arr.d infection

vras observed ; I patients were rated as good, the others tuo

were unsatlsfactor;', there vrere tv,rc activities should. be

i-mproved. liJhen consld.erly the process of nursing care in the

4 criterlas, 2 patients Yrere rated as moderate, the others

three were unsatisfactory.;

The infections and complications which the immuno

compromised. patients encountered during stayed in the

protective isolailon room 1,vere oral mucosal infection in

a1l I patients, wound and skin lnfectlon in I patients,

respiratory tract inf'ection in 2 patients, parasitic

infection in 2 patierrts, urinary tract and central nervous

system infection in one patient.

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6 Utatignant Lymphoma, "Sciences, VoI .258, I,io.2 (^o.ugust , 1974), pp.98_99.

?-Carol Singer, Mark H. Kaplan, and Donald.ItBacteremia and Fungemia complicating }feoplasticThe American Journal of l{edicine, yol-.52, No.!pp,71L-717.

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3-_-Bodey, Bolivar,

and I'ainsteinl ep.cit., pp.l-96-197,

Loc , c j-t.

and tr'ainstein, Loc. cit.

l'JU lz t'tLJ r.aUliguuIhe[I,0[1Ur.dj Lurdul r\ r.r c a- -- -,"" -v-H rrrgstur4ul r'-ru BtL n*uulri.r*,JgsuuntJBUJ B0t nunt"0c$1r-du3uuuul$ t'0uktlu.nrtc,Ub3lfrt;ulluuEt-{$uLLJn1N3lf;6ntpfi

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vAAn1rfl-frt?0?I0'lrvr-rlJ'i41tr6uflnnr:r rr ntr nrrfint{rr.orruarrayilr.,a.,rx

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ri..:qioruurrufio.rd Lfinnrrfinrto'irinryua]afirr r1]J 42 ,1uvuufifiartu0lu1?1nrrrfie,r#ototrjonrfrt 32 11u rlr.r,,funrrFerr.{uroo,,uu,,^,

fiTaritrYu ott t finotn nr mirfi'm,u cuua r finfin r fio 'r,,to r frnrrn u fiauaq*lfilanonffa

r,,r'lra r finflu? r rorfi ruri.: r raa'tafra ( cer ruri ti s ) fi , fiunr r6n r{0,0.:t, 1r

fl Tar"itfr'nLruor 1r1'r rl u r fi nornnr rflu.,urfiru, , r f t r ir r iulafir,nrhnay ,. iruunvl.lsdqillula r urfl a r fi olnu r au uav r fi ernr rfi r'r r

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t'[uuounit'IuurJrunntfl 'lmrnt o Xs I 7I nl tnn t,ro [u,rrti'lfio'lu'iio.r ilo.,: rr ay orofln1 ru ra

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n 0{nr v r }^rl vrra vahlX ,.'Iil, fi*,drrriuo ilo.r ffn ra:..r douiru , rJ.f,r ri,rrr.t '",I a.J r.^rr.ly

rrtudrii,r str6 nrlfin rd1l

trr n t ri or o.t r vuul r vd lyrd 1un0 r.r fr ,,ru'i fl trn"l :JL r urin i'er r r

e'11 ud{ r,ru t 6urfl'u1 r 2

Singer, Kaplan,

2Feld. and Others,

and. Armstrong, 0p.cit. t p.175,

Op.cit., p.1OO.

yo? I w I tu'onorniiurJ':ufi"[n iunr rilonn ru'[rn r ,nn fifl:Trlzra'rfi'q r f urriunr r

w l * "J :l

^.!a,-!Salfliltx0 t\:u0fl, [ue11t ttav t:dud tf]il (loaey, Bori-var, and Fainstein)"lirruor,.,zuonr rfin:*'liir 'iuil n. fl. 1 979 ili.rr.u.u $ r1u d,ri nr:r

n't ril4n01il"ltn t v nn vrru 11 r fi r'rnr rfin r fio"iun r vudlafin t fl0.:lrn uunfl r i utflntJU7'tvv"?xt'

rrnrilaurrnrrfrOrl r?il 49 nr{ d'rrrrqiru'lunoilfi 55id dr ruqraru'lul}jrfifll, a Y "'

?1niloflrJ1il lt.n,irdtr +: nF.r rraruanrrfinr+r'lufl n.fl.1977 iirruniotl

d5olwlt:tnlofiqrirrl 1oo rrufi'lnvrrmrilanntu'l.rnrrr,n 54 rlu rfinilorrurruay

,, i o, r ^ '{ .^. It ilufriernr':udlruniin.: 34 11u rfrofinuarulr,lig loun'lrlnrrnnrla lrfaI

rravfirl!fidfin trn?"[rr (cytomegaro virus, pneumocystis carinii) 1

o Xof 4tunfl 0 { t I0"r4 t Llu,6i1 t14fl

r{ouunfir?u wuumdarl.ur!ilnyrf,ounruau 1o,,ri frlnlatss a ) a. t I v

alnlutrua ttar tnal traal fi.: rlluf,qrar'lrarg.ro.r1r..ri,lu1u,raff iiJ'lutnryfi!., ,

ili rrl t o r 6 onfrfi ri r do'lun r y udlafinorn rH,run r uau n1 r ilu,rr rr,il r nl,lfi ,,u,lJ

4.y.--- X .! ", A x t w t vilo'qi mfl rud.r t fr oLtn t urrnfi r iluar ru n?o.t n't rfl n t rom nfi rln'[ nirn t fi odttrrul1l11-

filanonfi'a 0ot?uri (staphyrococcus Aureus) 2 'lutr.:fl n.il.1953-X .i- X ,45 v. ,-t . r.,' A A1963 [ ']flrr,n

rt.luln lnut a;,lt y r rod rrnulil tanon 6d 0o t T ud mr"[u r frnnr rmo

E o rl 4 I v I

t i,0 lrru]11 1u:J, I f {fl 1]11}lr t ra6 otlrnfr an

v EAafl11.1 Oflt10l1U?']fl t SdlnAfln..l

I r..: iruurura,l.o . d .,in. r1iu,Jf;ft rurdi,qrdni.o fido r fi nrnr 16. r {oorn

1_'Bodey, Bolivar, and Fainstein,

) .l -4e ^v a'0uol-lt1i .nf funa , r'ru artg,]c-tn1, ,lv9'

alAt ,0{ t elil, U1)1 73.

llvlv za .t e aaq vf'l 0:.J''l t 11 oilf l 1, t 1, t 1tlljutrAlJfl Xl lU 1 { n 11 {

'lrr* rii r * ou n r mu nar u r fl urlqrar d rfrc;1u

Op. cit . , p. 198.

allra v Lrd 'td, ri ?i41 ,

Zt t vltnrilauil1nf,u | ['llanrteynnl, (I'eld, and 0ttiers ) "[o,tfu.:fufi.]nf r1 '1, 4 4 s ^ r t ,l A ^ X efrnuruilrurv t ; { t fr nl afi ntrr I erunauuu{ rnnnlrnfi rso?1n r 6oaunufil an0n fr'dtlt

c4l^oX<-i1 lloot;ud 6nnaltfrErnrrfrer16oornalnrluuud ff.r 2 nailou'iur;ucilrlflrfirfiult,tijItlAAX.esvolf,^.. lruullnaill/tt nnn1tflfl [t0?lndrLnvlv,l tanonnd CIo t tud $1'.1 t 1a1yt]Jt1floud{nl,l! xn -

-, I ! I e I - r v 7, rA4cle6v^S.l4lvtCrt4v-6.1onnalJuu.t0u''t.tlt1tuttr'tnu tuJl'tn11yu1tnt1^ltuu?y tuernu uon?1nuu.:y!u?,.l lil", a. 4 s A y A ^

I I vl. a I

Qil?u:J, I I.: rrJn inum"iit':un tnnn1rE1flt60?1nalrr]urrua dtuuilruur tilerouUtIUv9rv. 4 va /{

u1 [ 1t0o { unel n t ?J0 ?']n r 6oa rrnrrlfil a non fi'd oo t i uo2

rfiolrfla d*uru, '[i,,n riu (Herpes simplex), gdinr

(tterpes Zoster) trnv'ltlrrrlnnTla'[rin (cytomega]ovirus) r6,I V I v I - t, I I I I

r",a.rrfirJnfiflou[n1'lur 1'lrrlur]iliu rrn'[uilrrnq01n']r rfionurGan'txrro{f ,n4 a .. X X .6 v v I vt te

annlsJn Innnlr et0tt rolu ft']1,1t u.: fl1nvrurrfld',rrr rdl'luurjruson?fiu 1n'u t our:ttrr,lrI I v vl I v I

t fl oau"lur r u r yr lu "'1 fl 0 {1 r nua r ryrJ

ru fi1 or iun 1 r fl 1u i { fi"lu r r u r r r a r'[ uu rufn4, v .4'd- ' 9 s s \4 v

" '?rrllu{d1fl [0r]{r0un, 25 -[rlnrlnnrln"[ria Hu"lurrilrdflyt.tut0{frn

tlvyltt

t sufiu t'n r r r I nru iln6 un r'[ r iatfierfifi ou'lur 1.: n']u1 eril'[u rJ r rn go rn r rl/ 7t

[ fl'], r ur dnyl']urt0 s n?TJnluyt'tul t nuoua.: r6ofilv ana'til"hjilt r,1 t frflrryurGanrutt

d,lu. uu, r flu ru,"lilfi rurlnrr il'l;3, II

tr'eld. and Others, .fu].[., 1l.104.

2Loc. cit .

1 c 4v ^v ^ el-t'tt-toil11, f1I"runn, lnu oqlt1flnlt , [tartt'i{{df u ??11,1''lq/

tr0'ltfi:J, 1,1U1 75.

IAtlJo

a"ivrir [ilur]J{na,

Titrun, r ni{r7l?,lt1td1r,

ry, (trutlntlYt 1

2522), UU1 26,Copyright by Mahidol UniversityCopyright by Mahidol University

,.nr.nf,,iofllrn 6utr,{nt6ua 1:rluirnrdlofia (rnrectiousI v I el I

mononucrecsis) 6',rtilunrrfie,rfiofi"lt:.r'leruou'lunrrilr; ryrfl iarruqrurlrntX ,.4 e

tqio 0.il. trfd (u.n. virus = Epstein-Barr virus) 1rufi*rlirlaoet A r a s Xl J 'o o'luuilruuv r f .: r fiErlafiqrtrr l nua rl r fierl r nilnou r vu; uflrtror?\::Jo1n1, flo.r', z r A A c 4 z q o t v a s X

lJvtr.ttlJetIauflfl')1 ur0i.r01n1tflo'lul,r.ltilfl[auflt11noil ltnltnntrnllnl!il1

^ o X ' - 4 4 \ ^ 4vlu X- '"

uf o t nertiutnrolJ Inuur t , 't [:Jn launt trn [n luruu.tou tut;utr.lnltflnl]1?1X " d vl -\ol - " ""'a 4 zs. ' o.lt1Ir0 0.1]. tltdu 3Jd1lrtflu1]11 [uInnil, tt.: [:Jn Ia]lflfl11etluuta tu '

X ^ X ^1", j I v

[5or l .fl1rneltr0tmfretfrrilutq,/lr;fr ttu 'lur]rn 6u rin lfierlrvl

? 1n t 60 u,nu6r' r un; iilc#u"[ er'l :r a']! mla, v I I- 6- A A .l 9 .v

uflct1 t ilunrtnn tsof 1iln r, 1'lu tljyl 1l-t4qi.-tr]'o.rrv4v, 1.: n 1 il riu r r r il urlqu 1fr ',fi fi'q ra, n o' [u t fi n nr u u rn ahu tn' lun 1 t in M r ilu6'u urn

I I A "r'v I I Xa Y.s

rdo.rorn"[r]^.u.rnilr;rrr??,/IU'[;ff{uolurn ita;tdoe,rmru t{ofinrrlrul*a'rI I Trtrl 1, lt -t, vl

r 1,tn1u rfluor traqnhfrqfivrh"lr,rzurJru rdufiiqr nrrfiErrfiorfierrinulerurnluqrJru

dtie.rtltrJ.on.uu.,u,n,,1u,d, aru'lfiotat d1u'dlurlaarx'1I

?1nr ^ru{1u30.1 ldaer ttarm[t (rera and. others) "lufl n. 11, 1g7 4t, I e' I v I V.4,a"AcCCAAA

tfl , 1U':',lU1',tUlJ1UlJ' t I.lgtCIUu1 lUAo{ y,| t dUSffi ?1n n',l tflgt lfl 0 1 04 t 1u

'l o'o^ .. X i I ,. ^ a,s vg/" lroitrjl/rt'dusmild']tltE?mt50rl 1/l?l1j!1nvrdnno ttnuflgl1lta3ntill,flnannd

r I I vl 4 1( cand,iri.a aud cryptococcus ) ttq"r rfio rrJiuu rfiluri'unqlryilruu; r i.: rfrer

Jnfirrtrruuti.l*riuuni. ,u,r.r'lul,]1ulrv r, i.: tfie,lafiq,t1l,,,rtttdurr^rfi'tio' ) a" I

illr'ouav ?o' ?1nriu':1u3o.r r{tno,, ttnilttnu ttntolrlJdftr0{ (singer,

Kaplan, and Armstrong) ", '1 a a < a 4 ' ', aluzuilruu; I r.: t ]rer Iauqrgttttarltr ! r{no]Jui tuao':

1'Fred Rosner and l{ans }/. Grunwald, ilInfectious Mononu-

cleosis and Acute Leukemiar'r The Journal of American Medical

Association, voJ.246, ifo.16 (0ctouer, 1981) r p!.JI.1TII.e4.

'r"ru anrl Others, 9-p,:.S8. , !.104.Copyright by Mahidol UniversityCopyright by Mahidol University

lt,C^AAutnetnlr9'lfltt0 rltJ 108 r1u

A44n1tflelIsOr 1yttuttr,:t

IqAnqfl t nn?1n [.rorrod [ 1 t0,

a v q t/l?aad ttariLnufletl (Aspergillus and candida) ?1nn1rnr??Fiiluiltu-tX I o o X f,rt .^"? rnnilu 42 r1u "F[Jl',] 22 r1Urilernlrfrert6olr frllunurtnnrl?l!u"[f]noufivl v l. v I 1

'61^lA{'ivl4u:Jru raurirfl tfrofrqrr??-tnrln unufrnl , uod ri,^roria6'6 trayda]nvioralufia

s) u1,rr1uflr#ortrnrurfirrrrirfir du,flrn,.,rr,lrri..r raill. vsl v v l,

I Id "O , ..1 .la e A Av a vAe)- v A 4 d 4ltllll"l L1,1UIJ1U t d?Jf m n'lr9'10 [ sor lu]Jn t nfln1uud.: li-l,u nf r Inuf ntf frnr t fro ttttnli t r u:t -''

'h,,il1 r#ortrrn uodrl,{0raaffri rfiur#orrfiifidulnurn uirri;ia.,#uai,

Cd{12 rlurrr?,tu{ l rrudeilT;rl*riuudr;rfiufiiqr d,rdurr,tu?lnnlrerr??fl14rvl y I e4,{ A A . d c A < ^- ^.. u -

Xfi flnr r 6cr r 6otn r ilo nr? lnuu nfr r iu r doin url uru n 1 r"l ;iln.i rur"[ iluX rfnfi nr ro x ^uqilrudfifrrJErrft rfiu uay'lilutJflGru;e,iirzuun.*i.:d,tuoftn tflot1fli1ulJ,'t t

ttinrttnilnfi n1rilnil.:1101?tilfi?1nrfrorr rflu tro.dtilarAafrtt uioilrnror"[ulnrfiav7'

(liucornycosis) rrarnrr'lunrlinurnrru rroillv{ryroifiu il. (Ampho-

. *'2ter]-c]-n 5/

(Jameson and others)'[lr,lrorrfi *q,j.ru, ri.,r rfinr]afiErrrr do,r.rrf,!,I vtv 'o s u'r-

d .t^ t .4 t A f,r - A v 7'

nlrf nu10u [uIrtr,rururn uaruil?urdufriarout-hnrerfrn "luiufr I ufr.: rtrllul- ^ I .t/

0{1u1r.:rlu1u1a il4fl1rqu i?F1}firul1f,uua r firr6u"luoir,:;nruludrr.rq li,,rivttvv

ilonr rir'h a1r'[d qi'u rJ1]J '[qr rra;fi?nr6orreonerru eJanlr [fl1r tfiurrnlrt

ttun'il!?1 tflutda'lqrrlnArlorou'[uroa6 (Trichosporon beigerri)j4,Xot.^^qlolr,ojer{ t llu t r0r 1}tOilfl'luilnrtut t 1u I nuililt[a, :tu30\: , 1.:n,]u ilot"lu6utta; d..: ur eraoulr - ---r ---

Singer, Kaplan, and Armstrong, Op.cit. , p.715.

2Ibid., p.740.

^Xyo .l v o X -A v I

uon?'lnuil{ }J t't u.: 1u t nu1 nLn r r Ern tfro r rqt'r6u t er'..: t gu t ?:Jfi',utta, nut

:-sYl^r",^y,rrrlnt r i rl r ? 1dn1u'iur 1{ n1 ul nun 1r u1 u'h nl rfi n r#ouar ur,\ rn r r?,ru,lilfi,? r 1.:

n1ilr'{,#unquanrto,lruu.,n ;-;;rrr,:rufi..:nrrfir,#uf, ,fiu.., 5,1u ffr,r,.,,.:^rl "11. .l.. ou v I

r nfi [uuil1u frInr r nernfl gurYuour t, ilu, { 1

nrrfin r #a r rri': r flurlrur.,dolo r do,r'lunr r inurfijru1 r n r 6oer n r r.liur::^-..^^l z )v t o. i I ti

flfrru;our': r frlilfr..runurn rilufrrfinrrr; i.rlr,u,o.,.r"luiirudf,r,rrrfierrjnfiso,:

t ^:1-.r.. 1 ,. .u)e o 6 X

nunufurra: d.: r aiumr'tr,l r frernr rfie,rfior rr1!rJ1 ua; r fluar r rflrqdr,.lrljrurfiufiiqr ,,rljrnrrifirfiunrrfi^,#ur.,ffo,,ol*rnrflud.,:rfrxq,,ulirr.-:,rar:a*ir

ur'[e,urn

t#ul,trlrt', d*rr.nli,,,l flrlr6^fr^ runi'[u uaruonJr,raraJufia

(Pneumocystis carinii, Toxoplasmosis) :ino;uru'lurrryila, frdolrnul/l

onau'lillrntrarmuri'uflnrrnr,4liqlrYu ilr]uiada uni"lrr :inl: r iluarr rr,r"lfit!!

rfier:Jonruu,,^rr'',1,iuirurfiufiirr nrrifiofulrnornilrrrfio.,fit,,,.,1iu,,,n,Jrfi.u,

1 *u aq-rtuir r #ufi , flrar, *1 r,',1,1 r fi nrn rrfi n, #uu.n tq, fiu r #oirunfi r iu-9 I y

r o{ a.:ut'[e un'[ ria uar r#o r ror rlarffu ff..: r duuonr r flnur r duti'un 116, rfio^

't d I 1)

'Iuruil':uus rf .:erolurru6o.r j50 rlu do,,rufr,^rru; (rera and Bodey)-el Yl I X o ^ X vX. v r . rrru{'ru trrr ryrhurualilrfronrr6nr6ot,r'.:fru 12 ,1u rlrJ 1Br nri,r dru.tuq

.(, - o .X v A e tu. .t ilunrrfrnr rfrora{.:ornfi rr trrou'lulr,:r,rururaua, [ fiotrur'li r nf,inr+r

1 Beryl Jameson and others, 'An r,expected fungalinfection in a patient 6 leukemiarrr Journar o{ clinic?1Pathdloey I Yot.J{, No. } (March, fgef) r pp. 267 _Z7O .

? .a ,,.rv Ay A-CIuour1r firsuna, rd'u ofrtmrntr ,jo'-,ruorud..:diu

-4 <l y i 6l vtr0.: tnu?nil uutrnurilu.Copyright by Mahidol UniversityCopyright by Mahidol University

"lunrrfin,r#e 181 r,t,,fii"vfiae'60 1c3 nf,: 6e,rflX.r -l j o

t "r0 t 1, d ilv\lulJ 1n ilfifii,)0I

Yad45 nt ..: nfl t il1J 3 ,By,'

dhrair r#ud*,r,juuua; r flut1r nrnrlr,{n1rd. r#u1uqj2uJ r n r6oer.-i/ 7, l"tE traert"[r'iufl,]r 1..ril 1

- ."! .X A 4, A X I r - t vt0l1t't.:11 1 fiurr3o': t60fr.: t[iudrtuflto{mrfrflrfrofruulroulunEuenJrulrnr6oer2

1/4V,.1

f-tr1?1tlt rfi0r?lJ 133 nf.r ildr ri,irrtrllnrrunfi tiutrn.lAavlvVtt 77i; n1tflpltt0[1tdl,^lLto\ia{}Jlr1u 24 nt: = ta;;

.,y_ 4 yq y t o X.l'd?pt l,^tU0..l ?1 nr.i [u 24 nt.: tilun,]tfrntfrof fUu

lJacterlaStaphylococcusaureus

Staphylococcusepld.errnidis

?seuci.omonasaeruginosaEscherichi-acoli-KlebsiellaspecS-es

Jii bacteria

L'!ycob acte ria ?arasites

-Herpes simplex

-Varlcellazoster

-Cytomegalovlru.s

-iipstein Barrvirus

-liepatitls .&.

..Ilepatltis B.

-Cardidaalhlcans

-Candidatropicalis

-Torulopsisglabrata

-rispergillus sp

-I.ilucor, iihizo-pus /rbidia

-Tricirosporumcutaneum

-iiis to pl asrnacapsulatam

-Cryptococcu.sneoformans

-liocardia sp.

. Tubercu...l-osis

-i,i. i(ansasii

-lii[. Ilaves-cens

-I'i. Fortui-tum

-I;{.Intraoel-lu1are

-?neumocys-tiscarlnli

-Strongy*loidessterco-1arls

-Toxoplas-magondil

Bacilluscercus

Lis teri-amonocytogcnes

legionellapneurnophilalegionellalike organisms

-Ilon-.i. , IIon-B "

hepa-i;i.'bi s

-Influenzavirus

Y 1F"1d rrr.1 Bode;r, 0p.cit, t pr4.

2Bo.Luy, l3o1j-var, and li'ajnstein, op. cit. , p.199,Copyright by Mahidol UniversityCopyright by Mahidol University

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Ibid.2phiiip A. pizzo, 'The value of protecti.ve rsolation

in Preventing Nosocomial rnfection in High Risk patientsr,,

, Vo1. JO, No. J (I{arch,rgar) , p.5jz.

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Feld. and. . Bodey r Op. ci t . r p. 101! .

Singer, Kaplarn, and Arrnstrong, Op. cit. , p.755,3Bodey, Op.cit. , p,)4j.A+*3odey, Boli.var, and tr,ainstein, (Jp.cit. r !!,t97_I98,5.rrrd.,u""

Walters Kirchner and Christine E. Reheis,trrwo serious cornplication of Neoplasia : sepsis and I,seminatedfntravascul_ar Coagulationrrr

,Vo1.17, },io.4 (lecember, tgaz), pp,595_597,

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1rod"r, Bolivar, and. li'ainstei.n, Loc. cit.Copyright by Mahidol UniversityCopyright by Mahidol University

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0tCopyright by Mahidol UniversityCopyright by Mahidol University

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1 Bodey, Bolivar, and. Fainstein,2 Ibid.. , p,2L5.

9p.cit., pp.2I1-2I!.

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riovr1flrirnrrifrfr'lrrYuountr:Jn6 '[unrrr*.rr6ur.,nr6onor:.ronu^"[i:oz6r l-s '" Lo t,"[u re ,irlr,:urn 6oz, '[u z+ r'e]r..r irayron"lifi n go% "lu +e d,rJu,:1^-.rl- X * I t v t t/erruiGnrrrrnrvrfio'trarr irirCIrfiori:ru'lynrrifitfi'ulrr,fiol#o ,.1iu,j.ooniu.,

fv"ilturruuhuasrrn rf rfiu2

j ", v o Xnrrnrreuilrul, r n r 6on"lur ru rfirJnrfi rfiu rr,1,ro:Jo.:fi'unrlfirrtfro

?1n11r,,,,,il,]rul, n r,6oer ?!rJ 1rranlr rn i., s i.inrrfin,#r,,u, irr,,q-|"r ": . A s v ,e I 3

i1.4t?rterutrlvr4gr terud.ttnn.ornrr'[t :ru11d'U nrri].:ntay,rr;i,i nrt"[o

tlddtrva-nrr.lionrrd'nrtudu "irflrrilrvqhnniu 01n1rLrdfi{ln.ln,.lrfi*r#arua1f,qro,rorfi'unr r fi'{ r nflun cnr nir y r fluorn rr qi.,u.,j,.,.: ru , ijuo

1 Ibld.2Ibiq. , p.2O1.

qniuflfid{ nitlnfi oulunm dmrt,]r.., fr,, j^,in.,.,fl

t rlt9l _ 1/ v-.-t^--) 4 v

dmil,]r'. r flr, rfi ,.r fl d1 r ,n?m nr r fi rr r #o r am"lilu:hulrnnatrrflor,h'iont lir,,druilrufriloeruy{ufrfififlltl0,1n'ulufio r#u 1"ifitiiar,r,

470% ltu

and Ana GiiGUras,

ilursine Clinicsrgeo), pp. 46-47.

. .4't " 't d L t

?lnut II.t (Tumor Fever) yfllnlou"lur.lilruuy ti..:otouUrn,tfiotlrnrilrt f{1aAf,!-

t irerl nfrrr? rr"lur vu v iil r nn r r ir f,n,,r,rv ro.:"tr'[,i^rr.,, oucn"lir r r fierrrnnrro?/r<e,.:6o r fr eniolrnl r n uonq rni'lur ru r diln..,16r., r#o'lunr y rol afinljruorofion*anfiIt,"]nr1ttnfi (rivpothermia) n.rlrr.,^,r,r*ruu"[iluxrrrrtrtu,,lfitrju',i;:lxrarfiahurnurn nrrfin rf,rd,fiu.,r,.,nr#orr "hiduay,,rufi,iu

rflur#0fi,'',,,rn"liu',1 nrrfllnr{rruio11,]nr.rr.r:,rrruiozunn14fl..rdiloerilnilnfi rruffrn, r firruua**rfi,,rfr r fl,.,,Tqrrrd*rrurlu,liru , r0.,fi,

xjrrdtrtrrfir'uihnrr',ooo tur, . irnrfinrrfir,#uruofi,arirraioyrr.:

,6rr^,r"lriruru ;rrrr-diJl..n. run,^, rnxr ul,r ieur,riofir,ruo.r"[u

,irr*d6'nrdlrrau a1?vrurfiru.:ornrrrjrn,uayfi"liui. r,rirf* n.rdu.n,,,r,,u,01n1rudn{30{n1rfinr#e run,iul, I "[:jlmng1ilrfiu1rUjrufirIqrr.fi

rn r rrrJf fiiurornnrrdn ,

^r, d,o r.nnrrfier ,#rl,hr.nr.rnr.u.n*udrr*r p

*r1 i t rxirr dflnrr fi r,, #.ruo r v *ryr 1-r r fiurTrra, y ru u r.udrr yrornr r fldo, ;Itrisr nru:Tdnrrcrauraioilrnui r rufiirr nrrfio,#orurrr.r,,llinuirrur1.,lu,ruarf,ilre, u?:r uR{,I,ui..r'[,jfiruro ijru;ii,l..uruocilmnnornrrrfiu.r

4' ' v J.. tll r t/.1r 6nuou r rrrilu iafi.:'luoruro.: uilru ,r^rf iuil.rnrr'[otra, t drJ14, ,do'lud*r*rr-l 'tlrtnrurnurtlnfi ornrrfinrrov,rufiriiu.:r,rru"loHu r,,^,il"li o,u.r.^iuorrryu,in

l,awrence R. Crane, Dehorah R. jlarmer,trPrevention Infection on the Oncology Unitrrrof North America, yo1.1), jilo.4 (December,

I lt 5-l Y eOO

1/'l' rtCI,:n'rrfn tau'I.n"[nr tru ?,]nyr1.r rfiuuru'lr nr.': t6u:Idrhry fit,tii,r ,,.,,,rr1ulvrrvfi"lr,rarrurrt,1141{uaont6onrerr'luirrn rou lnrrruun gjrudfiu,.,nlrfl0{n1,o X ,'o ",.- .X . y,.- r-.q-" rA4 Io' or, a v afln tt0n?t lcruntr tl1Jir [froi,tnru tnt:trny ilu"[r,rurrJfrfiluryrur]yrtn11,: teruyluy)

,r.r.r,',1.r:Jrvlfiuo'rn'lt3o.:u,lruu,i.oolu, u.., loilrqrr;rrurda.,#u rlrr1,

fi .': nr rrr',1 rffqlo.: n l r tl it u gi r u, r ^.f, 1 r u, o,q r frr] r ufi rJ pr ri;i r fi u fi1y a 1 u r".1-.4

u o " t' u !

vrio t6orr r ?'luaofl r dorrnhuou ",ino.:, ri.1h,Jun-,,drfl iruni.rurrr.du.

A a %n t' I

or o r ilern rr fr er riin'lunr v urrl nfin r :, renrrr 6on,rn, r ludinl i or,yu, fl,,.jo fi

*u.,u.^iu,r rriurrior,,or r,ou.,ilr,,J,du r,,,.o eAEr^--!,- , ^ 4^y.--- X ! " -rlul1 lt, u?,Iin 1 t ilo.,: nun,t, Ei er t ti o yr-.: o m t fr an r u uofl tln, t tan 1u t ufl r ruil ru

v ou ' l .Ja ,1 s 4 n v , 't 0{ uu

. Iuuozuilruirtitn rr nrtr n urjrul r n t 6oer'l'ur ru r n? 1ufli1rJyl1u?11 t nt u ,

4llt6lt uor ttn, tn0rnr'rfr (crane, Emmer, iind. GRGUras; lirruru'rlin'sfi

ffurYrrlrnnrr"ifiur.,ui,,n,i. ' 'J'! ,o* - u^',^^, :..." Jr., .." .^i,-.,," , l.r111yty[J.lun.itunuuil,lu tofuufytt/]unff

fiarrfiodu'r,{filanonfr.a r,rionrnf:Jlr,e,anfrn,,oro,.l"lurruyu"rirrnrrr,.,r,#u 1,1u,1ru,.,,

'lr.,,o u,]ru ,rd.fllu',umo , r.rru.fifi, flu,i*ri, riu'lr n r ?urnrnr rr,,,,i,]rou? lflru tuu Ieru r gr?'r?']n r oruurfrnrl-[0iunilnrryu'tma{rr tur; ,,)ilyh: t:1notnrroXvrve"lerr$ol/l,.lvr1\:?Litr m,:nCIon nrrlufn ?1nt60duflufilanonfra raioarE,irflr,

nonfro nt irr flu r fluiirari,qdq^firnruon'u1,]1, ,r.*.dr.l r n6err#r1rfl,rr,,ri7/t '1' I ' N jl ^

i J - - -, r. t -! r t)

zutJ':u nr r"[rauurar r rioa r':ilonouia ov d'ufrafi'ru]ru,,^, nuufr,,daer r udu..r flo ,, r1u1u#rxiru n. r'iiur.ugtu*.ri,,,i , u..,rr.,dirruuiru, fludo or r iru r*ufl

Kirchner and Reheis, 0p.cit. r !p.597-601.

Y "A t vi?"rlru'vi1lo{r,rulunluqunrrfinr6o (rnfection contror) rflujruarirnuuI t i) .

e-4w ruL,k !

rlru:-lr v'd iu.: ''ru?0{i4u1unu nun rl fier t #o ,.r. r rr1ir,rn-urinfinu,,r,r,i,,r r,,*r,irJruoriru r flurh rr,.,, d,.,,,ufiu nrr:rnrd,q1un rrir,,rfia 1

nrr"lnarur'',,.: tg","irfi'rui.u,du aruur..:'r#u^,r.,, aruorurTaol.:y.4,- 4 l" q qe eru u v .1/ i) e, t,ttll'ld{vl€10"111?1'0lt htrolnou ntor tfluvro':tlrrfino.,:'lrryinfinrie.:fi'unrlfio,r#o

(aseptic rechnique) nar"linrru,.,,.:'l,lrrrt nlrflnrtluur'iuunoneuvl^trfro.r t,r'lou1\: nn t tl nfrn fi.: ov"rruan:Tqrarnr r drfnuay nrr r fio:-lonrrrr'luiir, , riafi ,

f1 ^...v 4' ,.-.! a, , X j^ r. I y^"n;;tfl tJ114u\: t iluaruarilqviov tilunr.: t rl"rto\: rfiofiireu"lur i{n1ir nrlre u,r^ril,ari.:vqi.At, llrrvl9]lrur,l{ rfru'lilfrn1rat,:fl1uur'ir,turonrludu??{ r lrur:,Tuyrrfird,,fiu uirrnrinui

v4vdoiur vfiu"f,ruflra, vrilrufn n1, nhnllIJn rore,riouni.: n",11i r ndo.r drort*a y urr, {undud'r.rro."[lriuu rTrr1s,flu,,rioru.': r#o]rn ilrrnlrdrriuriuiu1/l I 1,

' 'rvr v cv ".^.y^.:^ v 4-- , o v Auu?r.lyt Lr'tf tJIr]iltnulo1?u.]t1..1 trurtyqyffuEto{etLia}1f,ifiri*y t,.,tutfrurriufiruut

ufrtornnruo??')rr:Idrtm; orri,',oflu4nui,,,r.rarjurrl,.,,ff.,,^yn.:rfiuilr,r,o v v 4 4 a.,.!.- q", ' u", oa y .. I v Id11,1r]rtlntaurJ0 r'nLril1 "[r,rdvotntratorruherru

tduqrorffe,ffiurfior]o.:ryu'lut)' I o Yl'lutotruilruff.: zu:Jrutrurirrlnuuurniru rndo..rlnurau.:n'ldfirrfiorr"[i"[:rure,^vYAlVllvilrrari.: fi'.:tot ihnttavill1r,lffn rfluuuarro,r r 6ournfi riudnrryE G,,ryrr"irl rfinr

nrtfiotfiu1uu,l.ufirlqrri ril,, ;tt- ^ Itl

Vvvx u1 rlul t n rrli t r-lu 0r0 { ilh n 1 1il6s 0,.r nr.llnffut,rnn i,: raf.: irrl r y yr rutI

0 11,1 1' rrn c n 0u uou Pr r r"ir rrr.l r ..: 6ffu fr oouu:r r fi 0il0,.: fi'u"[,i1.1, n

lv l^ j, t

i"I i,l t fi nrrrua'l urot:J rn7' 7t

nrt'lrrnulunge, (Dental Fross;,,^r"[i{ur[unrr.:ntlu fl,]rnr??r41{

u': rr u1in n 1, dluoe?,r, r n,',r'iiu,',r r,tfiur,tflo:Jr ouieryl rt urrlra#noroyir"iilA ,{ X r' v y

t ilnrn rl Erar r fr o'[n .in lr yro\: unun y r,,or r fi ufi , duiu n rr fi^u r, r.,no.,r, fiu

'l'Crane, Emmer, and GRGUras, Op.cit., p.849.

,,.1il r fir,fll0., ,i ,',*dlro. r,1,., , i,.,roor, r 6one,r nr r,,yr r nnoln rr6,n r auyrn iu,?, r*d1,{ n1 uu 1{, i.r^u, r donur,.:, ftu l,, ufl n r.fi ot u-, r, u. ; ;;il^s "r' ^ Xttavillttila Irru [rtmnilnilaoettfro (steri:.e technique) {niu rrnyuharu6'tnn rroon ffufi , duruo'r r ru or r fl,r,,.iuui, ul rndri.u,,r r'u".1ir6n, du,t/-!n.: tl rhlug.rriuiluod'or n rr r fiuuiGn rr ilflr16fi'r1rxjru,,^ rrfir,.,r1rliruua,rgrfr r.a r'i o

Ad va ) e' ,1'nt,trttunililru tr,^roilo,.tfi'unr rfin r 6o

, uilanqrnifinrrg,ruryi.ul,rrr urfirlrmfi riiu,doiuu,i,unrrfig, r#0fi,.:dn

^ rru r,ru r,1 ur tn .r,,r,r,ifi 1 iwu r u u fi eriluifinr r q un in i+r"lru 10., ir{jru

rrnrfi, rdoilo':fi'unrrfi, r#u1rlf;na1sru{e.,r,i.ufi ,u,, ,duiuunu1,l1rfio,#rr.nfitltrnam (protective Environment unit)1,,rr'[i,,,[*rrtmnfin,lunrr

^7rv v 7/

o, ria'lr,rn r':mr rduqr ru nh ffu J . u,*',r uu nn ru inn :J l, ^.,

oil rro il

1."1^ ^_- o x j v1. tA0ilo.:nunffqtOrttOtfnfr.:LtfnraOUfilUilOn

source) ifin.rd1, 1f;,,,i3,+

1.1 i;Uiru,o.,r,;1rru.,:uilnfrr*rr.rl (Reverse rsolation,simple Protective fsolation) rluudrru.ryj.u,i.#uofiru,fir*ruurua

(Exogenous

1Kir"hrr", and lteheis , Op. cit. r pp,J)l -GOL,

c'Crene, Emmer, and GRGUras, 0p.cit., pp.B{5-B{7.

3_. . -r br.d. , p. 849 .

IL'Bodey, Op. cit. , pp,543-544.-r

r Bnl MrjrjlLnnt[il?

ntlrtlnir@rlrrur uuuurrunLur:uLnlrjn ( u.rng Br[fi ) urungrr.n1.1krtptub1!- -F

| ^ I i 14 o"oo t^' I

:tr:li,,YLIL'ulltd loLBtnng

1 $ tLr t'0n@s l rrgr uuuu,s,L unurl nF: f.ruuonBrugt4iignltLP LUt0 t'0 LttJ f J [trJ U

1 Ugr4sruEmULrU r ] r. rgg Unr s- - f n o i o , n , J1!'ulltllBtluL(LzeulJtut@

PEUntn, $n!tN tLlu0 us@P L ut0u(i: ul] t't] i u No-s u 1 rutu,w r0 r,rl Brdt li tu r,0rr.3[r

sc r u 1 nlr irJ u ur, 0N c r unnru grr

Lr a r 0rjr r e!nu* gil*gtn. nio g *i, gn*p.*y inl Nct4nl BtutJt!^ o u ,ut0u3llstBt4L UIilsLutotnltpn;pgrggngr (uor1e;r111g

rrv a+ETncr+red ,(cuercr,J$ qgTH ""aa ,i"a*"'ro", a^r+ca+ord

elduts) Huurr: r.0.iuN0 JUIENEUnnN@nnl fiounr nunfi "f""i"f*'' ^ *r " ,;lt z'L

Bri4otrfi 1 ntB t"t1g0 J uurtt!lcctlyl0 l Btl'r,-qN0ruuiTsJrs,

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,u *,'*]i.}::ffi}[;, J;;:J;ilffitr alj

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onlr"ut 0udnnB 1un1 m unrr lonuun[ ngnuFfiurr,tki] BUnk ^

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b0 [nr nu.o nupri uirril-r1 uu r mun[I ^,

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utltLtlttlJ: uttuftu u' t N0 J llt p?tlt'kttlt'LtTuurTUB[r N J I

N0 r/tu r'r t r10uu url t 0 i nn g[ 1 : u,rln n o

t t o- | - 't auupugunufi u,nltl nbuogrnuu (dros r'prcr;ro+rr*t)

"ns, rnr[ftrnr*

onttusgr.6nupfiunn;rii^u*t:oruulcrr,iu,tnuot [rucsi 5 | | ^

'' a o t^ - ,.a r I o o r^LOrigol:u113001urJ0l,tt uL0: ppggl uu.r,rJ uuf uMu l Bl.dt r.skrlJuo;, ptrutur"t/J uur,^uunu l Ukl UJ tUnJULt ord

mu Nnu N0 kull n uungui'tott'' 3 U t : ullnu nNnu 1 Nnntp N0 krnivitllu 1 i ftt t40q,1 urs ^ b x ..u f o E, . a i.rL€

.? :^"r{,^^-3. F, x.io r", I2, t i/rl0il0.lnun,trfrfl tiolrn rfrofilou"lur1{n1u

source) lr,uanr.iiofu,',;rd'l,uri1rr'.0n..,u ir,,,1,,,

. 1 }iurlfrfirurfil,i.,r.,fiu,i.i.on,.,u (orar non-absorbabre!-o o'|antibiotic) uril'iuf,Lnlrrnru'lr,un r.auen"irfiu rrrulnffufiuuayfidteffiu

(evu = Gentamicin, vancornycin, Nystatin) uffllyil16l1u,.irdrrllu,rul,vr'r\: tfiuorur,,,Ju aJerl:rrrua, 6.1n.'ie. rrarnnfliL00nrunJ,.,onauso.r o i

!''[ni]nrrfinr+r

rfiurf,'rnrrlurri, lu,ul irurlruirro,iruo,,un rruffodu z nfl.lI v - .. l-s . I r ! tl

ila ilu il n l r rl o,r rYul r n ri,:'l u'i n zu a r fl ufi uuu ou

z.z nrrliluttflfrruvrfinrnrnfiutirl.,,onau (0ra1 absorbabre:J

antibiotic) lr,u1i}il r uult,rrrJ?u ra c6'aylr ruyruonmlra (rrimetro-av

. prim Sul-famethoxazole = TI,IP/SMX) trurf'terzua'l1nlrAngilAn,trnlIo X i ' ^ I Yt .' l'v Ifrertfro tilofrnur"lunauuilrufir]r,rfi rflufi1erir rur/srx ffnrrriornrrfinr*o?1nuLnfr , ? ru r^ o u,|,.rfl,fruartrq ., du, rl? uur fi uufi,m d:ro rruu,,;r, *r^ r-f ;ttt,,'lur/smx r rurYuuTlflfiru rtflnfilunndu inru rrinlr yf vrGnr uflunr njorn-unr rwloilA /i E{ n- I

frnr r ro6n m'[rurrjr r r nyiueit r iru,:ffr r fiur rX.,:ri,,rl,r r finnr rfi. rdulr i.u iAn.,f,fl,.t r, lumi'lunr ru n'l i ann r r fi nr, d uluii., ulit o i, r nil in urrurnn .r

3 , io.:n-un r rfir, r#affrlrn ,dun. uu'n ua rfl1u'luJr o nr u lrr u1il

i6nrrilo'rn-unrrfirr,ilurandu,,r*iuufforr. (npr: = rotar- protective

Environment ) , rpE riuiGnr rto,.:rYunrrfiu, r ffudaur rol,,urd^. , rr. rd

13oduy, Bolivar, and Fainstein,

%irror ep. cj. t . , pp .615-616 .

(.Eindogenous

0p. cit. , p.211.

nMuu03pttutuu.t4t0r-ruuulltutttilBOtnr,E1BtF[@m1 ntuujBtrltotlt nB&,1uG r, a7 a . ut o l^Y' --;;6'-F'--; .-";'--

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A- ' ---i'-*'-, r 4 4 ^ - | r-

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gs t 0kta-4

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guuul2 tF. Z n[1Uos]r'T1rNq, Nk rBuuktuL[TUnMNtLn"'ti'!

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3-K.D. Bagshawe, R. BIower, and. O.iri.

in. Hospital to Control Infectionr'rVol.2, No.51rB (September, 1928),

Lidwe11, rrlsolatingBritish Medical

p.585,Copyright by Mahidol UniversityCopyright by Mahidol University

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(New York : McGraw

2sue Thomas Hegyrary and 11'K' Dieter Haussmann'

rrMonitoring Nursing Care Qualityr't Journal of"l{ursing

Administration, VoI.9, No.9 (November ' L976) t P'1'

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'&.ig., PP. 19'41 'Copyright by Mahidol UniversityCopyright by Mahidol University

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Measurement rtr NursinP: Outlook,

1975) r !p.764-759.

Case for Criteria Referenced

YoL.2), l{o.12 (December,

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rfiflo,.tui.ui* rrnrn m ufronu'r. iur^, uoI q .. - I ---"'-ror r ru rufi r fi n6uff':r,ru n brn'oirlr',trnr, *,,u'ii 1 n yuuu n.t orrrr,i.,.r n i.v I l.v lr_,oua y Bo fiomlulnirfionr lurYu ua r'tu'lilnrrmu

3 . u'',uln-,r,dui',u'torurrnfirnr, rJnl, o,,u'lu,,olr, v ium nfinr, firi ouu,-t-r'rtlJlnutm.toon'iuttqtayuill?i,ft lur..: t,riu

44 v v tl -s vilil''ln rlr-n4\:utJn G t0 trayuilru"inilnrrnrLnfftfl

i14U1fi14 4

v o .4o^\ I w v

ohururrunrrvr'':uun o :ia lh:-nrlaffilu1n r ao fintilurr-irrurfiu =v

5 lJEv

100 10

llvfirnrrud"lrlnr,r'rfl , i, r.:.ufimr r#1i,rrriofi'..#u nrrr,,^dli.,rnrrliru'iu iu#ufi > 6o fi.rfuiouu,ro'l J

ruoru:lru"lrfrnrrnuerl?t + ito fin rfluioun,

rlnlmrnrrYu lu;uiiuirrlirunrr.,,^'lurrrfi! + finrfuiouo, eo

1,11.1?nYl n?n, rlJfll Iftrr?lli

"(--<l6:,-'

IGf,-"(GJ=c6;{-=

1,i!1U tfi9tI

A o-4. nltf1[rnrleuilq'rarU

lv4^4t tCI{n1tnn tsot dri' Y I

lrrou ts (Ertrur

37 ,5'c fir,hl

4.'lunrrfinny,,t,r,,fl*iuru,I

n'ltti.l1l{

U-vo.l riu"l,il lrafiaufnirflo,nvrrifiuuv

rjfi?u 1

5 - urn,uuu i rua vrorfilr m un1r,*,*dJirulilru'Ir,,,n', y {uur mun-ul, u'Iioru ru Tu r ff'ufi',:ur r o.u.,Ju rrr r rdn.rurli,,u yfi nn yuuu, o6'uiou.,t

t l-v i,rrrrYr5'f,ht*LluJuugl ,fl a{ ttfl a ;'i,lil1fr00nrt uhnv rtu'ut u6 ufr'l r,lr r :]? uu rri ur rr n0rr]1i,{?o.i m rn *a 0u

rl - v ..1 , I 9 ^

t .^ r..n, , -{

tulvrl-l ll 'rltrtnert r,ifo'l;rd 'lunrfiiifionrrr'luuurn"ln'i:rlnrrfinrvrniu rm

,urfr 4 nlrnria rdufl:Tq,,r,iiron.,rfinrrfioraioflli ;.;jrrir;-^r*,.i;,^a1101?r finnrr;6an?mn1rfrnu4r1i d.. ,fi*firludro, ru, ro iu ?1n, yu,

olf^vrrarfiou'luuo':rLunvr'r',run r+ {u rilr,ifir,nyuuunru.lu ro iu,1i1ili,rfirnrruf,Lrnr'li ro Trirfiud'rr,rri ff..:ri'roJ.u,Ju

\ l- r

fr'.rrTunr rr,,^iiii rul ilr-r'Iu,a u..fi' ou1.,

= 87.0010

Iv4? ol 1'tuntlttl 1vtil1una I {

,urni{ 4 nlTnrr?r rdcilrTqlu,dronrrfin,rdoraiofili

wl Iuilrumufi :U

^ 4. lvnn t :Jun yrruu I qfr u r run:

vlY.r. o 11 ! t- ,tnlLnlrnrra luu:.nnjrr 4 fla0f]r ru, tratfiou,luiaar:rtunllu

frn tilunyrnru rodu

fi on r r unr rn,ua'l nfu iuu*,

iufirlrnr rfrnr*r

85190195

s vt I

o 6-'Iuurjru 1 11u,duo.rr*uvr*1LrIadu'rufionrru,,oluvi4]r?.aCIn

rJ'rua1 urnruuuffr 4 .r4:.r?nu1lruyu,,ar'li + rflufrrrarr fior"linrLiuu

4 .i2., -lu ' v

rqduao.:nrrnunr['.:ra:rnfiur]rulr,ru rLaruir"i:rrrJ?uurflum,{a r*a*narr,,^u,l,'luryfi'r"lrr fftttu I 1 u

avnv umr r odri oru v.ir itfim ,r lnr r.,,udiirr'iili',ra ro, ,^.,io,l1uiloo

ttun tm y t yfi'unua,tfln1 rfrlta11

fi',.rrYunrLLu, rod'uroon. re,,uaffru:rndui.ur.ud , inru ne,n r 101

du,j'iuiloo,,un fir,tfir,ioua, er frr'r.*n.*nrrouur;,rrrorr.;;;;'l:J

t n111Uil 1Uu

n?n ]..l.Jnl rfi[ralJ

u:J1nyt

4d.nnU_lu

n vrruur qduw

a4.nat ilu

r yfiu

nilfl1U{t

iltunar.l

II 2 3 4

80 85 BB B7 85

,-oii,rfirn r*rir'lnr iior,,,urfiu.,uv,,uur odur.nu,,,uuduiru,xu 5 11u

'4'- I I I e I

InfL*asv!1]11fl1nx1r,uav B0 fitsnrufrn.ao,rnrirqroi (carter) fiuirllv

niln1'i^r1rg,[a1ud 1 f'n irfirn ,, ,i rffrff:i 6rrn ,,,uuil ru,,,u ydun r ril iurjr ,r

fi'rour r r au

1,1il1fiYl

nlrntta ti^I0o'v

rJo'rrYunr rfirrt fra

3. AriuurI

wifl O{UillU

r, rfiu"ifi{.u*n*,,o,irruo,li.r,fo 5 *u .lrr,,un.riio

-Yo, I

^ w Y.^v' -, oua v Bo frtfutiorrfi ?f'rr r u? cfl."[ n i::n yrLuuuou ria rdiln 1 rr] iurl r,:

1nfunr ro,,, iur*

1 nhnl1

waU:Jlt ,

1. r)rronila.ff ftruylJ

Vvfnlm ron:ir torTu

i?tua yfiruiIHrltl:tmfi

nrr iln rrlu fliur,liolvl

flurruo{ rfiniuraio'tlz

rrjurlry?1unTuI

aaa.ooo.a.a

72.73 54,55 50.00

Ibid .

runLijunol: uB tstu ktt"p nLJ ZI

ugpt ut\ix0 r.torikrutus L' ull B rr r

BU3 Z BUJI3UllBr3 e rftnn[1

z nr\uJ runLr Lr\u l,,nrdLBLpfirun,t_ -4-

,4ntnu"eLdLIBB]Brlit"EtfrupJtut t_LLAz 3 ntt t ,4 !r u [uyr u

Ltd lr 1 N J I : ti i1[ 1 ur u J tB^uouL

J r, ulT J U L

BL J E nU1"(,.4,t[Li:IUlJt{}tB0t]Jr{ruurtl

b t,uutuunnff tTJU ] t, rr

' " -;,*-,,".,oUXl,L*ullUJLU:g1151,1-3au;n'uulcIuJntpuftu[,u

pNlB uftorularui u I r r uurul

Mui u, ur']t\uJ tt or'u[3r1],0irp lr.n*ul unrr ro,rftu urL 1ri]r[n] u[.,iJ] rnflLnr&]uI

t' ur-r]]mBglr 1 J uus ul]L 3 B U 3: u rjllB rpfiruuu,iurr,oul, *r ,i, ur;, ;,;-;;;;;;;-r , G I ut ta I I ^

-H'-U""-'X F;

urrofn[1 z u.i1Lp ]rJrul-rJnluirpl;.i12 0r: uns Jrunflr u;1ugg,u1qcn6:ucur gnllI r'u*uun*n1ry r

;gqrr[ s uu: u, nepfi r uri-u;il

1.,u r : un r s r-r^u; g r urtu nnp r

uiflnrp'nu,rri, e nFluuoNrrlrLrrulrrruljn*1g*ft.i, nrr r r;*i, nlr', - r L '"i- n Ya L r'gktlt3-quJBU0UUOBUpm:urr nut z z riu[,rr;3surlruouHnr[fi BLJ Z

L BUU';jruci uuugnrph^ u,,r1 rdrl!ruriuJuurrun;,1r..sLNt11,11rru![rnu,r;;-;

urru-I J uurrJ uri.r ii.u'u., uri.irnfiilnir..,ornrnutr.unuurni;u u.unuriilur.$nuLurBr J a i' r^ , _ t r t , 4

ntojslr.drlJLUilur.r[r0M1u0r]ruru,upiu,,3ruil,,ul,utrui:nnr:3l.rjULruuo

llunsLkr:u3u1tJUUt1u

tr l4t4llI

)Copyright by Mahidol UniversityCopyright by Mahidol University

Iqtl r,t {fi 2

?iltJart1ufr1?0{nnilfr'?0u1{ S rlu

t a?}/lI

ilru 1,1U1U t 1.{91t

nr r ifild'u'lrn Anl rrlnt_+1

Acu'be Leukemia

Aplastie Anemia

Aplastic Anernia

Aplastic Aaemia

11qJ.:

1l rl],t

l,iq.l

, rfr:JFint.,.1

+o fl lrJryn:rfrnu1

ee fl h1:1nfinur

1B ll I orfir yfinur

zo fl lrtr yCIilfinu1

fluirr l,+ ;u

ruuljlu li 1 Tu

va.l lvunIru1.ll 14?U

uhur I r+iu

t4uIlft

( rntra-

cerebral

Hemoghage)

I dU?1R

(Septic

Shock)

dr,,r iun r l nLra'luuu rnfr

nr rnua"luuu.rfl^o^.60 irua,U :J t -'

ri^-.^ r X- : atnruni tntte luultl niruaulte n 6o

J v d o .l .- ern u1nufl 1 r r flT uu,t 0{rrunrrar r nio.:'ltnru'lulao..:

,0',:a..uJ,^rl;unijrunud z lifriouu -- 78.03

,oua t 59.73 fi'tnr rr ri,l :

gl | -zu:Jrurrufr: 'tni:tu ? wl ,

,4fleJil1urrufi +

-^ ^ "'

j o )o) .^v - rn111.lvr 3 nr[[lJH tAeilr0uayl0{nlrnrrafrzurJru'[eriu'lurau:nfi

1,_1.,:lr.l v d n 1 -- v

I nilmi]nl r tfli uiJr,lo..r rrun ttav rnic.r'li,nru'iuro..r

[ 0lJ14w?u:Jru1J

11.JllH1n't 'rinul

o? ?-1

73.33"

66.6,7

73 .33

80 ltt.tt73 .33 186.67

92.E5l|51.53

66.62l6o

73.33 i 66.67;

50 '|86.67 86.67

57.14186.6T lgS.lS

50 l+e.q l6s.az

50 I 6o lts

n yuuur oduiru^,

7i ,42

84.1 0

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ljnvuuu,odu'lu,nu.ufi ,,dr.,fi'rrrnfinrro..:,i.ri.dlun.ru,,oJiru

v? ,! lJ

nlr0lua'luur.u,f,u.ndr,n fir',rfiui,uay Bo.5z r0,:a{}J1fiaiirur.,ud, u^, zel I r

roilav 66.gr uar G6.76 ErruarryrL ilj.ur.ufi i 1fiur,,urrlqu,fiuiaua,i ! o ,o,

er111{d 4 nvuuu,oduirr^r?r0{n1rr.,,,ufiuiru1ilrulrrrn*d,rtlu

.i - o * ? ' wl

r n urn u t.fi nilnt 0.1 r ?1uulfi'lun1, n[[ailLl1r]

x\rJ?1lril1urrud 3 1niufv

fr -:irn yrruu'Ina r 6u.rfru fi oi

49 ,51 fr..:qn lr tfi +

ta?rwlU]J1U1.1

a u7,, ?ri-tnr r ttn,t rerrra I nilr ouny

vF4 " 4

luy]fl1m rfini+1

58.82156.25

46.67161 .51

76.47 l5g.zt

57 .1+l>+.>>

+6 .67 l+S . et

81.25I64.71

6+.z9l7t.43

69.23 Jet.Gt

5.+ .55 | 46.15

5c I >+.>s

73 "33

5o l6+ .t t

75 178.57

86.6(,1 e7. 5o

60 161.5+

50 l6o

+6.1 5

71 .42ll58.75

66.67 l6e.75

53.33 l+0 .t>

50 l>6.2>

Inruuu rqdu

80. 57

i i o n'lrntta'l"uuu..d , _:il:]irqtiuurto,:nyru_

ufi.ruur,,*u,odu,lurrr.ila..,qofiu ijrrr,.,rd .,

finrtiurouav 97 -04 rota.:ur"[rr,,nui.ur.rd , 1r.,ir.,ima, 86.6!, uirrrrrd , 'l*iuuruuuuoud^.au

iuu^, 63, te *'oua r,.,..rd , ' !

I * ?or -v i ,nruuurq6uriruar?0\:nrrr',r,ufrurlruliru'lu,au..d, tfiu.:ryuairirr.ruoii*ui,il

I.!El1t',l,l',1 5

ta1fly1

zurl':uU

v4 " r'!?uyt)l1n1rflnu,)

1ou I t oct

66.6Tlei,a+

75 .Qo l9<t.9o

81 .81 I 7u

4+.+41 5u

'100 I t o<t

Bo l'66.67

90.90l 1oo

1OO lB1 .82

60 lto

81 .82

9tt.9 t

BB. 88

8,1 .82

tn, riuu r qd u

) t.2tY

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ruoy 5 l,iirnru,,rr'ln,irnurriu fi. rtuioua,l

fftrrrrr.:fr o

0l"lr'.).114 5

Irtv di ^ X ,l ..,rtililQll't t :'i.tn,l ifrett:ior,tl oir'[tv I rl Itaucr 10e .l1urJil?u11ufi 4

f>6.1.7 tLaY 57.62 n1:JA1ffU

nt,lilrimirnii + r'Jurffinr rnua r iiovl t - t --

u:lrurrufi 1 r?,3 'lilf rnruuu r6u'lur,l.:r,flfio

n r uuri r td u i.r ua, ,, o{ n 1 r n uaiiirirul. I fulu*r .:nfii +

r d a r rYrnt nua r doiiils n l d r or,l r fi n r f, oii i afil i

ta311wl

ruilru1l

f i,n r runrrnual;ir;ounrvd^a1U1414'tn1 t ilnu,)

nrtmuI

t flCIu

1oo i 100 lr oo

o(); I

1u0 I too

56.67 | roo

1u0 110!

':'i':' i". 1""

100 I 1oo

o<; ieI

1uo lloo lroo lroo'

;/ ;H'.1

.iw,r ilnrln:+rfi,,:fi?n, rilfli1 rnruadlii:rl u,u,,r,or r,)fll1im s frlnnrnr,,,r

1: .l ,4 o- r - ';- '-'i*'

;"uilrulruu : "[ntrnr le,*a'lurr:r.:nfi + fir r6'ur1nurr,,,rrl lrrrrurrii

Iir y r{rnnrnr n:Jtun^ r,: 1r !

v? I Iriilrurrufr 1 nllerrra'luuurnii : uay +

[ta; z firrfi'r,n,,r,-,ryolr]fit

vl I ourhurrufi e'le,finrrnrra'lurvff:Lnnurrnfr t?ru,r 1 .r4rJ1n

I tl !J, t -" -'--^,i

druul':eril 1 tzr3 nufl1,,{n1lnrra"[:rfi

llIJ 1',]

clv.iNr, flLn0rrl1i^if')

ttu:tre,ou'lur yffi"hfi

l,ilJ1flI/] 3

11lultil1rt

Ir{',l:Jlflyt 4

}'^ofn0 'I,l]-tlfiyl 4

u:],:,lrr ufitJ

av4n{n111\:i'l 7

,.tfl111\:14 7

llil1'tii 1

nlnt I:_l

4 liaY 5 n0lr'11l1nl tnttafr{ 4l!

uil1nu 2

l* i trin v ttuu.t triut ouo ytl0,tfi?n t ,lJnl xfltta"lurraayiiulftfiel o il

zu rl r u'[ n fuo r ttunfl 1 u t ; ffu nrttt r ttol n 1 t er tta

nv uull t ufruroua ,10{fi?n, riln1rn[r0trre rnnnl ]!n1 rflrretavlIJilll

v1 ct:t ft

I\4 4l

t:i f)

iltunar'tt

til9rt

nufl1I{

tilf)aqc

t iJfi

nr*r)1ul n?n tr:.j n?n, til6b. e1 I h6 I gt.>+l 6 100

G6.761 t,]a I ,r.rrl f ,]n

Bo. 6z lilrunart I ee .6+ lilruncr.:

j,4,.571 f,la I ,n.r.,l iia+s.51 [ r']a I ur.,ul r,la

tlhuilun;rruu,oduootfionr-. v -t.r .wj., i,I I o

llJnlln[nl'1't'+llU':nfin:JfU"lnrfllnAO'trnt

vrrrlnilr ilu11 ur-r1r11ilfr : 'trrr-rrnv truun.:aqrfio irru, Bz.B5 rn.':n,.:ur"lilttri

u:lrurrufi r ,

iuu^ r s4.s7 ffufru : 1u..,,,riuirur.,u,i , finrfiuiruu, T6.2gdruzu:Jrurrufi + ua v r "iilrr-,n*r,ur1nirfiu.,rriu fioiruu, 63,84 Lrrr, 61.92rrtuarfru

it! " -i !.o

,,uar1[rnnrLruu tqdufi'te,iuoonnurrffunnrntflt0{nlrf,rtra *riaili.,u,',ud ',

,llr , 1ilrunrrr*u*jlrryfrunnrnr,^:J.r,n'*.* ilirr# .;- ;;, ,nr r r,ua fi"I nfiiir rffunnntn"[ud

r iioiinr,,rfr.: ii.r,,Ju r *u lc,unornn,,,r,r,,1r,,J,* rru r*dii,u1nru*j.ujrrr'o 5 ,1u i;rror,,rn,'lrrrr*d', ,in*i.rrrr*, , ;J;;;; ,

t,rrr rr.rfi e

n, uuln o6' u i uuu g, o,: fi o n r r un r r n*afftru udui rr1o., i,fra,u, 1r-

fla00 t rnrflfinr*r ttu {a0n tilut yerunrrm,l},{fl0{ltlrfltta

tanylvlruilru!

,+9.51

7 4.37

53. 18

{41 .92

nt[fl1ilrt

ilrunnt,:I

:Iun rrtV r.l

[lJRt9'l

t.ri9)

n?n r rlJftl rnttan vttuu

8,+. 10

vlr)-AvqAr\"I. IlOilatnu1nln1t9rn tflo oln1f rrnrn.rOilunvnl, t:J6uurr:Jatt0{?huxil

a s a o l'I t

il? lflrTla luzuilrutreiar t tut

iu,,1ur...,nd,rTroJr,rff.r 5 r1u rdurfrunrriflofulrn nrrfinr#or'.fi',u rfinro.:rfio rrnv0lnlrul4rnroufirfierdu'ru,.,:r.:diirnrrfini:rryu lfr*rauu-t6l al

LUn1r1.l14 9

Aa v .< - u I a,rrr'rilofru1rn n1rfifl rfroiirqu rfierro.: r6ouovornrr, f, o X 1,, r ^ I Ium r nno uyi r ri erfr ur a.: urhu rrn a y r ru'lur,:.r fi fi n ur

I nSyt1'I

Fllt 1{i4 g

lculcornia

Pneunonia li

Pleural Effusion

Oral iioniliasis

ii ilacter.1a,1

l-nf ect ioi:

CeIIuIi'tis Rigirt

Arms (orntnfl

in:gr )

- cls 1rl*r,6u.tA v

(IU?AU?1n01nlr,

0'ln1f ttdn': t[At UA

:r:ray )

- Candlda albican

- Alpha Strep'bo-

- Streptococci

Group D.

- c/s l,lrr,#u

Septiceniia

?ln ldon-

IlemoIyti_c

Streptococcl

Group D,

E. Coli,

Dnterobacter

qa vSn1t1u?qu tfh

9tAAcnltfit It0ytl\lu

n1t 1.1!1

e (flCI)

t alyt,, I

zuilrutJ

1 . ]riea j-::i; i bis

?. 0ra1 iilonillasis

*3. LIiId. G.ingivitis

4. Parasltic

Infection

1. Oral lloniliasis

6 Bacter:lal

Infection

2. Pneunronia ii

i?espirai;ory

Failure

S1.;1n L:fectionel(:J bleb troc?n

uuo{fl"Iilfi1m;.: )

IAAfiUet3o{ tr0

- Iilebsiella

Pneumoniae* l.9l

.. tl [ernt c/ s

ifiofrumnornrr

iloclk worm

Stror6yloides

- Cemdlda Albican

- Klebsiella

Pneumonlae

- Pseud omorras

Aerl4llnosa

- Enterococci

"- ?seudomonas

Aeruginosa

- un c/ s 'tuuu7/4

CI1n't I Ltil tntoil

'1. Septicemi_avA

?ln tt0

Klebsiella

Pneun:onia,eI

r ruffunrr; r 6onr

o00n [udIJO.irrnt

.{ dAt dur?ft

SepticerniaIA

91n t flo

Pseudomonas

Aeruginosa

Septic shoclcAI CA

rta, t dus?fl

Aplastic

Anemia

Aplastrc

iinemia

nrr ifiqfr'uJ rn?'t I446{

nlrflfit fioyl,i,^{u

n11 1\:1,1 9 ( rl0;

t nlnvlzurl':utJ

14il1U tUflI

nrrifrofulrn

:lplastic

/Ireriia

ApJ-ast ic

A-tre:eia

l, IAAd

n1rqtfl trioyirrru

Abdomiital. l,ior-ud

Infeetron (lost..

0I Append ec-bor:y )

Phlebitis trii:lrt

L{i-Ii Gingivitis

Peri-coronit is,4( H,1':0n0n t dL?1n

vaA'IUn?j0,: tflo

- t"to "1" "[J,lur#o

- c/s 1:1*r,6u

i'{eiserj-a Species

Alpha Strep-bo-

- Diptherold

Hook vrorr,i

0plsthorchis

viveri-nia.n

u-Tun r rudqnilru.qn I

Urinary lrac.b

lnfection

Parasit i<;

Infect ion

n"rrAn rfiu1usofi r firfiun,.,uu.nl r uurut0 ( cominu.nity

acquired infectioi:.)

n'rrfier r fiuirru;iffu 'lu* uru rn frfrrlru*ririlnrrfirrr #er r*r.,t,t yr'.:o ur,: r fiur fl,rJ16.: r fiern rr fier r #oLrunfi r ?u Jruf,run lrAn r #o;it,il r n do.,ruu ru eron,i'urzrira,r^,ruffu ,,^r* ;. , f,nrrfinr#0fi r fier"lrrIr {mrl1u1a (rlosocomiar infec.biori)

lot/i44ax"l1r ilofrni,fr .rn1 rfr fl r fi o'lur v ur-, 1{,i ./r.u

1 1n 1rfi n r #o'lu,a.: d1n t ff.:X X ^,^i.*- . o!_^ 1^ -.rr ,r, v ^ X?1nIt0r1tt?]y ts0uilntiiiU) trulrnr,iflet 6o :lu"Iuirilrufi{ 5 r1U nlrnntn0t0.rrtuaLrncfil,i',i.,t:,ru'lu,;jru r r.,u irrn,,,rfi*,firororrur-Jyr1\:rfiin,lru'lluas

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9"11r1'1Yl 10

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n 1rfl fi t $Oljo.lr rUililt y d lyld lunn1.tvlt

CI1n1rttnf nr0il?1nn,trfifl f 6A (Septiceiaia & Septic Shock)

qhuruilil?u(rruI

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14 oruru{u

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11 siuruiu

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0tn0gl Copyright by Mahidol UniversityCopyright by Mahidol University

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Y l Pirror Op. ci-t. r p r 514 .

2Souurr op. cit* p,541,Copyright by Mahidol UniversityCopyright by Mahidol University

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,unrrv,": rrrrruriu a1ulrfirr,16o,rd"il,flufiolrrri1n rfiu,ilr,,rio roirgrfiule.rdl^.-- ^ d ,i ^.?r-.^-- v-.A ' , , ; ' j e t rl/lnlO'lttunvli tu tt t ilunrufuilertoutro.: t eruuri,i4nnufroyno.:grufi'unh{n[ua.:

o X q-.. ,^.*'o- 4 | -X

t ,. 7/ I I v

10.:n1, t nn tt0 turirt ilg:tnzur {u r raur rraa'tiloolu1t oy il t oruurfi t:rr'lilrron u rc- - o ' , ,- o A d n I t vqelul r utottrt:Jtluilnqnn,tnir fruorttarnrruru'io nr,nurrf,nrflolt41rn1.l

t.rau"rvllou"luuo':nnrruhoonururauYu rfiorJo.,:fi'uuo.:y,rrfio, rfinlrn rra, rflunrrn,r,a

Y yyvl

dn1il u?fl a0u"lr,r ona t ffn uur er 1u t ruffutI

^ ttl!)i1r1u.u,d ldrrfrrtrnfinlotri.rr.,fi1rn.,rg,,^frj,u

vrr,'luuirr*flfifi,trufi1orunrrr,,ou{'l* rffuilrunart r r1u fiu,,flriuuo,,,r,u,,:hudn 4,1u n.,rq,,ou,Jlur r6'u"lir6luu'liruur,,ru,oduu,]r *i.ot.irns 45,91-66,g1 (6',rqrrrr,rd +) d,-,,du,,rnfinur,luiiru,,J^Jr.,uT.,fi rrrurnr:Jnr rruu,oduru,.,,ui^rrrr.,,i,,,u1. ny url*, oduiururofi , ?r0.rtrl I yt I r

u:Iuunayrruflclrnrrurr.d, t (?1nflrrr..ril ell,^, rdui,or,,,r,,i,firr.,,vvllounr uuir"iura,rrfif,firnr rudlirrnrrq,,uul,,ni.iuuu, uo u{n., 1o r1unrrerruffu fi,,rnrr'[sriunrr:Jiuih.rfie (ntnuurn ts, uin tls)

I t/ .!i/ v t1. rIo'lranrrinuryrururaduro,.r,fi.u,rarriim l^":^^' v,-: 4 r' !. tt l,t ,, a1':iJ0n0!!|nFlt':Pl1u

drjr*rerruiod:rur r io.:nrrarrfiourhuff.: i rrulfrfun.,q,,^u,jrrr{.0iuuu, 14,67 - 38.oB ?rnnrrffr *r*r{.,ldX.,ofiuriurrirl,t.lriru,,un_9 I S / 1 a 1,t IIn[tn o1?"rtutil,xvru o1?1ru?iulLla ttvryruilrrohurunr.t:r,irr]nfirriyrur

rTnfinuru,'r,,ru'uarrTnfinu,',*u,',r.udu irfinrouerr,uiirrr,.,r,yu ;rr,,-r;ri.riuvlv{u'rL1n xr,:u,,ru,)1rro fnfrnutr*r,Junninfinurr-rururu Jrrirrjlrluroiunourrlr"trjlranrrntrainr.Xjr, ?1nn1rfinurro,: ordl frarfnri rdurryunrr:-lrv ifiuruan1rflnrdlurill',,d1;;.,j.u,uur.ulro{,rulula:Jryqhnrr,rurr,:,,urura

qcal-II rurild I

u' ,''",',', uurr'iu, iuon., X..,flu,luud?v flq r

^rrr,,riiiru,Y,'.ruurura'luuogrhufi'rhurfi onr ruiiuu^, 23, 25 irr*r.r.ulr,r,jr, 10. fi . u

,throunv 11 .53 'i',e, r flufion r rufiufl:lfiuoilua, nrrrrfluJ i.r ,

d.. arrnio.:fi.,rtuanrr i 6Lr'luoFofi ?in, .ru\:1u?,0,:

a{ur oun, runrrl r nfie, r #o,lul , \:ulu 1u1n^^- ^q^.4

t | 4 ' 'J. * trrurrilfr na1111 iloirot ro,auril"luJr {l,^ru1u1afl y 40% f, r#u,,nrrordou.,

edIA'ord1 r,lalrnij,Y jov

finhfftxrirulo',.'i.u ,,vffunrr Xr.: fl06,: , flriin,',, dr.'rqil1.1unrrio.:,iunrr

u. r#ulr n?rn , r,,rmfil,Lnlirr 1 irn, r flritd, du j.,fi1r,

firr?n rnda."lunrr

io.:riunrrfiu,r#ut aul, (rizzo)' .;..,;,.' r.'r1",-*r;;-;;;;;;;;lu^l^vv

t o {ti"illlturrn vl,^lu luln t fl iLfi 'r nrffq'lun m rlo.r rYun r rfio r,f o3 uunr.,nf,,io i,iu

I v e s !f I vt dllo tluv 11n': r'i'er'lra t ataurfirlru:lr v'dtu,:1u3o.tl4ulunrununr rfir' t {ourylufi'u

tur/rn uil r v ohr.r ru irn v rinfi n rr,,'^r,ir fluil r v l r t do r rlufi .'r n r ru dr ffig ro ..r n r r X r r f, u a

q i ' oX i ,. 4 v e"[u t io.:n rr ortiloil t lo t rjiuu t fruutYrnrr unilrflerrlr nLra r ?]Jn n rr r:lduur o'': r ilr

I e v 7r a g'1"', ' -zu t ,'- s i v

aOutfl'11t0\:[unt|n1 ?r tuu t0':t Iu z toun.:uu:Jru'l,eriuntroualrrutq6urouavI I ' ' r' '-.--

99 ttnt 99.75 frqortrfro{iltqtnnrrzunurflr,iltnLrarq,Jn flaoar?unlrrlduu' v ' ,, l,^* v a

ro': r rrfiu nr'[l:-lgmrrn 1?r d'r r n* r r,,u'[il*r.i,',u 6.r r rirryunnri..:6'u"[rt'lufi'r!,

i^ - -u -.o-ur '.r. .-- 4 v v ' ,la 9 r.^*d1iln1rn1{uo [.rrtuutplt?utl4uou 2 lorrf n t ?"l14it1i/l6..ray rau"[lrJfrffi

z. oGuru'luuhuunrgrfi r:rr'lofi.:n11u?1 rflufi.uuuuruo,,rn 1rtrfijt/ t1''vvl

,vl l-l/ |rv6 | ,.ivl vq alu[ltj?u 3 ,'tuyl tgrrun?fi, r:Jurouar 90.91 - 1oo

ltel y,4vly[taruilluon 2 t1u terru

U7' t/O,.tAn'trntLa Iugou.rt0u n

A9n0r,tuittn torutouat

tt1, 11/

n 1t [ 3 10u1l0{ ttun?1ntLy,ytull

v 7' i,/T*.

t?rTUtOUAs 57 .14 t U0.:?innt1U0\: HtflUAt0.l

luiud ? ga.:n1rfrni*r lnru o iuurnuiru,irlrilu'll

1 nurorlnr runrrlr u,fi*r#o nilvuc nufl1^*iJ,o*u.urarurGud,tr ^ v I

t t0{ t n}J, 14lt''t 5r.

2Crane, Emmer, and

?-Pizzo, 9&,4!. ,

L'Crane, Emmer, and

GRGUrasr 9.U.i.!., p.855.

p,616 .

GRGUrasr 9.p.*!!. r p.844.

nur0.: rlulrofi*uiri',u,rrrdrnnu,nu.,u,i1u*of, drrfiirur,.,ud, r,irin

:r:uu r ilor ornfi'rr;!rutLa*3rfi1r: ra'rufi.: r rr!'Ja?Je.:n,.,, , ,.uqru*,,unff.:,,uiiu,,, n

fi,r iuqern ruro.: n r r finur "lu, Iru fiXa;u, fi,{.,,,,1,r.,rr.,d r,"[io6rrufi..r r ur]ilav. I l, I I t, lr r, o 9 .nl I t)l 9/ 1..-.qt'trrrriurrrnfizurrrut91l,1o{rrun

rtornt'[u:ir; rfiuu^rrtr"lrrrrrrruiru,ralrriul,]rlr vnouffunl1:ud1rJ'rr n'lun rr iuirt,r, , i."lrru..,,,i*, qouu,iuu,,rnul,.,o,i, udo

4 d , ' ''- l"'

'l'1 t.tJtlotttovrnflrnrld (cr:rne, Ernmer, and GRGUrasl ltlrarr!

r fiu,iinrr rrflfiG1uraoo,,unflu,iu,.,niruriu ff*,,*ru' T{rr1rr1aLrCIy iirufirornuorunv nhnrr * r'1, rfiurryuiorrS,:n,ri.fr ..r1r;;;riu,i.,ooiu,dro,,,lujrr, fl,of - 4 71 1 y '-rl-

fi'r rr r flu yiry.o ,,rr rrfir r uqua,,{n,',, ,r.r,jruo,,un r ruffii6ilfr,h*r,,0,0't n 1 r rr yl rnrcufli 1..r I ilor q r fi ulfi ul u.,1ur * i. of,

3. ^.r,;,ir,duu1r,i5,:a,r:iud.ns.,r{

r?everse rsolation 6o'o.Jevor.:il0 r:Jduuro.r rnr runnrflerrirnuar?un l,jn'u,iaa,rijrulo,ri,lrrrfiu" :. o elra,rriruurfiu':xrrru nrr,rirfionr ru'rrruil*ri. piru r r,.,u1.rriuru, 1oc6n z raul,ilirr, " x vt ' ' $' ,,1

A"r, - tt:9y^l:o ttavet:hudn r.rru'[e'iltoua, 26.e7 'luur]ru

: rrufr"lnrf,unrrnuo"lu"riofiuou ,,nrurrfirnmudqrfi1,iififfilrndqr,6o,duon,,,,

i.ofiu ,,ri.1ue*, ndgi.u, i.u1iiuo,,un ,i.ri.d*r.r.ur11il.rilu,.,,,uru.,,,ig'rfi fi ,: I Gnr r lfr fianurio,, r.,ru o,,u n,,rif frriu lr.i;i;t r;.;;;*;;ilr,rlfi:ifilrrnnrrwiul,l 'ryrfi6.:"llarr rr,r,,Tnfir nrrudrfrq.lunrrrjfrffior*d;r.,*nrrfirr#a do,.durrriuu,fiuulupirru z r.u;itrr-rn.,r.,,ufroiuuu, 100

' a ui'l'|. y l^ ' ,t u

r,LCI??r rrau-[Errrzuilrufr'': z ..oxlurrogrtru

rfiurriu ,rurfi'rr,]rruJjro1i1ru,.,tLut ulttnqlfie,ruou r o.r *iuuffoa.GoriGrfgri6, du1ilryrfi rir'L \rtu;uu.1il^lfi er'r uilr v r fiuzua': rq rir r"l ionie r,, ioi:j,,o r"l ilnro Guru r d, r fiu uon o rn,yu

1 Crane, Emmer, and. GRGUrasr 0p.cit.r p.849,Copyright by Mahidol UniversityCopyright by Mahidol University

v|l u o nru'7t I

ft ilo rr n rr ilo r a"nrv"truuil,lo,r uunr ru'liqrfix jru.r.r fle'liar rrn,iuudr, ,, r1:r"l ' v'o- o z, | - t 7' t' I-luuo':

uu n arriuXii'u6.i r fru11n1,]u t or'lr'iar0.: t ?.ruil1il'iunrlfinrrruilr: rfiu

uai6nrrrJfrffinuto trxrfiiiru,,u, nrri'errqriuugun rJdu.,u1unl1l.rdy nrn rsu] ' o 'o , rre ,r ' d ! t01{ a 1.:ilo zurilerilrntra; oun"[u r viu,:"no ie, r fluo.r nilr ynoudhfrrgilor n{ r ai!1*q.fiijrurJfifi6orrura6'nro.: Reverse rsolation liu,i.ooniluo

tt vl4. 'lutrluru nlrifr vital signs nrrprrr:IAnrrr,,ar,lrdt..^.: -.u i...' " I 4 v dr t.!Yt t.t,1,llrlrolJnn Ieru toruutfrnutfrurriu rrnnrrfinur ylurrfiu:Jrufi'le'fufionrrt'lu"- Z" Y'g'- o ,"- I I3OurOuCIv 100 1 t1u tu tofu 2 tlu tin z tru'lnriunrtfltraourrl,1?1,1f ' vl u tt y r ' y

,oila, 14.a9-21.43 druIlru:hu 4 rlilflflt?1ltu,lfi 3- + nurrli'l:Jythti

firnrru'luiuf, l.u,,,i,,,,unfr r.ruri.il 1u.r,,ri ierrjroyr rlud.ororuarnlt6l v vs o - 4 " "" A v o '-l,ilu t? 1 nu ternttunu Iaran 1 nu fuvrnoruruurfrl fldarr: rrnr t fruuh

6n 1 nu uhsrErflaar?voonlJlrrlduu6n 1 nu irulirur.uii"[iiun*ruur6uq-,"-.-\P -t u - y t

"s u u J o 'o

tu?ouuu v\u11n?nr r!gt{nn11yt1 [nru t oruutfr tfr 1..: nur fru,)

5. urfiuuarur6r;iti *alrfiurrYu*urirlrtlil*iouffu luirfifl7'l. Aur'- I e l v vQilru r rruil-[nrtun1rfluaroila, Bo uilru z rru"lntunrrnrrauou]J1ni, u' r-'- - -r,--'-

' 'l'q/ v 7' f Ytrtardn z lru'[l"tr,f,unrrerua'iurofirnu e1nn,]rd'{tnnuuil'luzurhu 4 tlrly-.^-_ | " ; t - -o r/ Iuunlryl1.11u30{ [?1t1u1ytttl].:.t 1unuruufltOunllJl,ll"t1yl (Functional Nursing)i^-.4-..-.-..- l94.o .i o v. c vtIeruurrrururafriuiinrsourio.:uriler l rlr] rra,ulfuiltrytluon 1 r1u LrrJ?1

^ a_.-a .. ^ l"l'" 4 e r t ' u Ao?rlJUlfiUttnrU'l0eln Ier LiltlA1tfiu1nil tTU 9.OO U. t[y"tt?.t1,1U,]]in?rtLUn1' try I

rYuur r:rr'trj'luzuilru

: r''^ f,'1 tv - e\ voy rfiu"lerrrilonrrlfiruilruloru Lulo 4 irac i rflu"lil"luffnuu; rdur

v s , , lt r.J- ' , rrrr, s^-", at v v ttnu Lrru r rruutiry,: tilrlanur*rro\: {ru t,ltf,,johdA'.ujr, ,."ifi,i.lru.dfiI!

t irhguagi, ufi u.n, :rll.url rflu, d.: * rurinlfi #, d u,rrn,,, g,,^ ;i.,rr,

llo{ttul ?'tu11.l tot,turfifitr t tr"[r]oo'rohrYnr uar"luff:rfrafi'rzurjru rfiur,trulrrflu

,duurn,',,,drool.nrrfi.r#o1.. do,.r,,6u,uu*,.,,nur'nr.^ (crane,Emroer, and GRGUras) - 'ti,,urrrrr?1lt1uto,ll^lr.,u,lufrXjrrarru{,iud,*ra

dj.^,i--.:l -.e' v -eyr9r'lnqflti4lyrdltJlf nnr Ier tlartruuliu,]u1aIortot"tg (prinary Nursingcare),ru.r^uf,^ra,.,rrrXjrunqrfir,*.lXl;u,fiuj,.,u.nrrnrr1ilr.,,rrr.

lTtvll,rn m rruril r dur fi''ura frnn rr'lunrr g,,ux jruru,r uunu;1 nrr ruri6nrr so,r,*u lula, i", r. 0"[ ir rffe, u:rn.:'liruxirr n {ua'l ru'ru,,ui^,, r r,rr r i*u.,r.u d rrann, un l,.vl i)

wururaq:Jru'luuorrrunle,urqilr, 1 nu (case Method.) uarnrlufitornrrI

r rJduuurla r n.rr,,* r r60urL0; n 1, rnr.dxjrrli rru{lurloyiu lrrr,.,ri.d'lfinrru,r,ada'.n'q,,rluiru ,du nrrnruaqrinur n.r,.Trfinfio.,nr.ru01n,r, ruduu

vtt:Jar nrr"lraurfiurra;urfir, nr, [?,'rrrfiou,rrar'l,i^aru'. r rracfiri.ru.d

'lufi:rrruohurunrudv nrn ria v'lin., d, u, rfiu fi rn r ru'ln,darurr nuh"[rtu iou rfi'ulifimumlr',r*ioufi'u 'lumc r fiurfi'ufiiorfir rulnrri., ,rrddf;ru i6f,1,lvtnu"harnru rurau r r::fi,:,TEr"'ru.t ij., d1il1rn 1,r..r uuunl rnun'lilauruuu,rriurrzuu

Inre inurso.t ullt,,u r flun"rr:Jr; utinr t ratrrar rrr..: ..r 1L1910o , i^,r,],ldluna r r,,uiJru.. .? 4dl u,

- o X lvlrue c t nnuafr"lun rr:Jo.: fi'un rr firr t 6oun ru:Jru] nuelr {

G. n* iern r rrfful afi qr'li, uduo i*d,ru n r s?rrs d* irii*

1 Bodey, lggf,€!.2-Crane, Emmer, and GRGUras, Loc.cit.

t l,lfleJa ,b'

-.^-^--q1 I - a A v. -t tt y tvll tro.:nrr'[t t nior Terttun t au r;fr rfio:Jo':rYu"[l'lra r finrnrrfin rdoun zurjru ahraiunrrr1--.:-^ Y Xv.a-- t d o I v sS o e vttnrun?nrtrulouuutrluuarro ttio': trnnrtil t nio,t {ernrruffuJafin trut;ualuilru

J V" t i/.., J e o ^vt J..e , !frr'[Ernamil1uo1"luuil1nfr r (r,lur zg) iu.,rfiqjrudlirrn.rq,,.iuuu, 100 1 ,1ut 11"- Er n,uu u ''[:r'[erir

3 ,']u rravdn r rru'[rriufllr0rrarouar 28, j7 ot]r,,:'[rfiu.rrrfiqjmj" I -

1, I v t, l..t.v e vl - t-, ,t trulltutnio':ierteulr1,10,: rrnttruurfi"lu"lnurlrr'ltrYuXrJ,ru 6.:'[u"te,iunrrruu

q 'X J "".a^- -t- .l ." j--1 t- v-1 .o v jtutt0u t.lttdr'r.l [u tuurr t ?11,1u1t,rf{ llnr vr,rrinfr{n?1ttdhfrqsoln1r uun t nio,t

"' r'l

" a, u 9'* v''[stqirtyzuilru Lrnc?1 tl]uoo.t [nruntrun"iur]Iurlr.tU -t-

7. fie,flrurTufinrua cBC : Hb, Irct, wBC, pMN [t6i ptatelet.^1t l/ V ltl V tt I -yl I I 9"[ruuruo.ru:]ru'lutofiyrrrriq,ilrufi"lfliunrru,r,oiuua, 1oo 1 r,ru 6nu lJ ! ''-

ll1/l2 t1iln1tnttaour31,111.itoua5 63.54 - 71.+3 tfiO.:trn'lurcur 3 - + iul,t :J

,,rnd,i.rutuunri.i'hl'li,Tufrnuurdenllr,ruriuofii.u iru1jrr6n r r.ofir"[r]l1-..r " x l^ ^^^r-!^ - ^y1- .{ 'e" ' J4tel t un?fl t, lJtlou t u0{ ?1n tuln rr :lur,lneJa t don I ruutuo..:naoer t r n rfr fr nur

^'X'o- a I el < A y- ^ !"[utoiluifu

rfru': rn rr errra inuruil':ul r n t nonuu nlrgrnrr,u nrr t il6uuuila.rI'UlJ.a ", A. o v : I 1 .4 1 a ," v

30\: tja t aoett ilud{ d1P|OJ leru t rvut; t vuc ]i r n ifl t aoor[ar t lct t donrmnh!1nfuc s lt A ^N vV v4 o n"'?vilua l,erunt..:o0nilrrtnrnrouyroy trierilu er-.'tfiunrt:Iufrnzua t6oer'[ruuruor

7rl I -lr 1t 7/ ! r I urplhuorrrulu r?11.iurfit,lrrufi.:ornrr ril6uuurla{ q'}rrufnfi.:fqrarfior rfirrfiu,11'

Lra,1'r.:uriunrreruainurrfioio.:fi'uuioui"hnr?run,n;audr,,fi*fiulile,ufi'ufil,

o o "r' v IB. n1t tl"tttfioerraio'lu r.v. Fluid'lr,tyrrfitari,ruitrorfit;rrm.,r

avo'r-oYl

o f, a X " t ,e

uf t':tuyilvttvt.t ttilu Innerttuuttavnu; (cotaman and others) -[ertauo

| ' ^ v a v d s ,, | ?'t v I

ttutl'l CI1u114u{rJt tltuuurJljuu'lnnlt Inututdunoil rrarilhn11ud3o1fln1iluhduluut-u4.1 " ,{ 4 a v ov 1" I l'

tfroanrrrutil?o.iu:Jnfrtiuflrilfrruf.:"lunrrat un1nlu,lfl1rdalrn (Rntiseptic)1", A. A t I Xs ,l , ' e s.r ) a. ,.trl4uilrrdurn1il rru u1?r'ttrotrn1/rilrvnou0rlutotofru E.:t:-luurfifrder nrtnr"[oledufi.:liu,].ouuu :o iurfiuirrf erf,ruuoanosoaJ zoz; lnurfin,orn'rtrurj.rI 4 '- a. " x r f, " . a dvlrtvr.ttljurrnlu:llloonrilurtnatnrrt 2- 3 il1' fr,r"lu1t{T'{u,]u10r1il16uelI

1Donald. A.

Infection ControlInternal Medicine,

Gold.man, and 0thers, "Quideline forin Intravenous therapyrtr ,Annals of

VoI./!, No.5 (December, 1971), p.849.Copyright by Mahidol UniversityCopyright by Mahidol University

fflirturu'r"litun., r ooJloludu zz; Jr,.riu,,oan onaa; tot; mhnrr:rdyorer:.^"-.Y.] I .1. . a^ vX I ,-'t. Au,,- 1'tJ11lu{n0ul/l?vtH4\: tgll ttflUa?']nn1r frn:-rf ni.':frurulrfruilrufi"lnriUnf rntta toUas

56.00 - 97,5a r?lJ 3 ,1u 6n z *u'tifun^,rg1,,uiuuo, r r; r r-re.zlornnr r fft r nerrlmngirffr*u ruru ,i.r,l,.rfi ,ro,fi,du, uayfnfinur,,*r,i1,

dlrtt00tr0fl060 T0;a rfiurour.: r6urnrnrrud;orrrilrurituira*dur,,ro,6r'luel

,;rrrulrnr6oe,orriJriu0,,,',,6u,i.rrrnrdoernrh,du,r.,r6on,rar'li^.,i..lvelrourrir rvrrl;n1rin:lrnorfinrfl1run1r ril6uurtrja,::rotua r6or, ilrsnouriutrl I uv I

X,rru ,r^.floro,.r1rautlfrfirw e,j rflu r raruru orffuo.1,j rqriu:rfi1,iri..:ui r r*dA nV y vl q,

?rut,r': r6u'iranrors,uar urtrufilonrdoyfinr6o'lunr*ralafior'lera..r ,duor.n!

n'rr t ?''r, r 6or,uor"lil^.r,l",tilunrr r,rraru0ruf.:tra, r iluur.:ul ,dr,i.rii,.,on.u1e,uqrr.:',#ud*rdru1r,q "[il,,,i,,r*fi riudfioiq.,rufi,ari.r,d,,*u^,,r,r.flJ-----v. X..^- -. d^ yi^- l', j c A"^utan0nnd rrartfi0ltnrilCIu r.:Ererlriluilolto\:totuutil,lrututa. oil..ruifu

, I 1tl I v.v f t tl

r fiuturl'lul t n t 6oe' traarfi"loiunru"[lasau1ilau 1,1:]1n?,tnn1r t or: t 6on7' 7' I I a .-y

tutrvEto,l"ludltuloutilur':aruru nllr,rraaog,t6onrnrontdurrnrllnoertdone,ra.u4trrl

tijutdutttt't (venous cord) ilrvnourYuraut6oE,tthtyrrayrrnn..:rutfio.t

orn rnie,riogrnr 6..rrr*r,rmiod,,ro r6u"lf,urn do,r.r r 6o.,]uunfo rr,rr"lr

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2Collin J. Mutton, rtl_. The Management of Intravenousfnfusionrrr Nursing lvlirror, VoI.59, No.21 (M.ay 2Q, LgTr),p.67T.

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unu6nr a:rrr,,r^ ,*r,r^;..,

lPLrror Op.cit. r p.G12.

61 n'[a u^ r a urrv,rfi] o non fra,,ri,,u rJ irru.,: nr r fi r r#o r rriufi , drfi u, du u r,tlv

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tlt{,on (Gingivectony),,0r'ldrflonnrou"[i rrffrrrn#uryjrutumian

lGeratd p. Bod.ey, ilOral Complicationliferative Diseasesrrt @,(January, l97t) r p.f]9.

2saro"r Drei-zen, Gerald p. Bodey, and victorio Rodriquez,ItOra1 0ornplication of Cancer Chemotherapyr,, postgrad.uatel'{edicine, Yol.lB, No.2 (;rugust, 197il, p.80.

of The Myelopro-Yo)..49, No.1

pnlrlrLut0ure

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l, I I

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1^.Singer, Kaplan, and. Armstrong,

2llia. t p,711.

3-..-Kirchner and Reheis, 0p. cit. r

0p,cj.t., p,715,

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uilrt,^lout

Ield. and. Bod.eyr Op.cit. r p.1022.

(rtnzuutn t. ,.rn,,rd , ,r. 137) .,iirrr.rd , firrr,oyruqrruu.*4 v o ^1 .-v. 1'- ^'!'f,ilrJU1lru\: tnoumn{uuu'[nirJnrle,rra'[uzofrr aila' 72.7) (nlnruu?n fl .

; ; vt rr

trunrrfr r uur r:z) uaru:Jrur.,ud o do rfio,ruu.rdoererrfn,^r,duotyvt'

orn'ludrrurua; ur:Jfr'firururufi.: s ru l^ul,]1. trrduum*ra,iod.,ro r6ura,^7/

l, - I t,

rer"ir,rarruh fi, urr"[r.,i:rnrroLra'lufirnr ruffonJr.: rfiu.: iuuo, 44, +4 uayI v

20. oo ( nlnuuin t. I1un1, fr te , t s 1nu,1 136) ?mlJani, finurd,tnamvaAd av 1 vdvl t,il?r t uullnrr errroytzutlnr u o fi zur.h u'[ rr ir.ifi zu aqro n r r fi e, r #o to .: u u a u n y il r rarirl em rr r .r

nrtfirr tdoro.r, rulryr,.r.r t Guuru'iq

1unrr finurnFofi*ui.,fiqrjrufifi e.,,#rr..., r rrrur41'.r r6uraru"6 2, 1ul!rfiotornrfiniloeruru 1o',r,lirur,.,uri r rfirrnrrr:_roe,rur'run-rf,,I.,lu,du.v vl ..tt I vrlurJorr zurJruf,1t g'.r uutlt!'u raff',:orn'[iiuutJfrfiruv 6o rrrdilrfiffa uay

ovi6u fi*u{rti..rirliq,,rij r flurLrr iu6.: rrduurfi.rrorr'tfldru; r flu uonrrttanttnu (Nloxalactam) lrn#u"[:rf,'[ian ilorl'l:rf, r 6u.'rfin:]nfi :lr snouy. . A s o I X I d t -t v t vnu?'lu?uiJl tntvla uvlurnfru fr.:'[urvuvurnnhouriu'il"louar lfilfiurfiu >Ga luu3

^,1 v I

t uruugfifi r ) r,rrarmqau rai:rff.rnirri.:arurroului.,un..,rfi. r#uif, ntai:rel ! vilil1ur1i]vr l rilnn116rrrGo"tunrvualafinrrnale,huua gj.uflhq.: uurrd,u

flaon oruruflderrfia"luiuurnrfiur r r r /ru3 1uzuuqfid :l {rd + ?.{n,.r,4aa7'tfrn:gr r fiernr rv6onornnr rfier r fiu,,^rru.raru'lr 6,,r1i,,lur^uerailnoria, , uduo J, u

. raru'h ruu.rr,,i111fifirr.nnmrdon'iuiuull,riiruianrr6 n,uffulafirrilnfiuavdTrlr'u1u'101f; ro.r 6oor*,iurnoflailnoocn r.rrufirlErrfia,luiuf,ne,to

-.4 tr'

- A ^ j't

rrro.:ourir'l:r"[rr t*ufi I ?0,:nlrfinr.rurLrrrfienmy:]uu,utrJ,::rryrnrrraru'loi'ou .ll t rtuai i':sro{"[avroua0na)JnCIunv rnfo.:rruraru"lo6n [Jnn1r,r,ar,#ur,.,n rd*iy

v,rr r #oql r,l rruudrra * u6r, uui. iir urio oou,j"irn..,r.iu nnaon ua y ohu.:u

fialnr rlati'r n.: orrou,fu'll'[f, ,,ri.,r11.ruulrflfi.ur rarurfier ,,r]n r,fi. r 6u , in'' I . t -t, e/ I r'[ilourttuttt{tint'[rdrurrnnunl'[0, urLru6..: rfiufiiqr"luiud r r rornrr finurCopyright by Mahidol UniversityCopyright by Mahidol University

rvuu141{ r6uuru'lo, irrxurda,',ffqtro.: J.on.u iljrupurfiflqrfi rfiud:^^-r^.&-,. ^.x X yc dl/]iln1tr)fitt03l0{ r vuilu?1n t ijottnrunu:infrornrr I urrr.i rra, t flud,t plrrrornrr r fit.r^'le J " X t , ;; i.-; ';t?ar tn r.l tilaflrrdvLori (nera ,-rnd Bodey) lrutturru:hu, r f rr,orur

^ J^ o N ^ v- -l r rlvn0{v1tnfln1rflntrofl}J 125 tltJ nrrfrotfiofi,nrmoufiaEdcrJoerlrl 6o,rflu' , X tr q" I a_ r X I,oUav 31 Lrnr til1.td1tllfln,trqt1Ud..tdft f 60fi,,ruu'[qrrn tr.ln!traa1 Ltn, tfr6o1 "l-Aelldun1ilfi1lolrlunu (ulxed organism) I ztrtutflnetttarnrtut (retd and Others)

^7't 1^:^^1.-.^.1- 4 4a ^ .l A A x,1u.1'luij'iXrhulrti':E'rouuhtufro{tta5ilvri..:rfrnrlafiqrr1?yrrnflnlrgrflitgo mu?ulv

1 oB t lu rur:r rfi n r r fi er t 6o ornrjoflu l rJd { dfl ue r r fJud 1 i 1,lfln1 r r,r 1u:rrn d qrr r duri'u2- trl I v .r/cl ', ' Arrs .A A ct o . ,rl lltlltltll u t ue'tu:J tonrdqinr tfro"Lut v ulJvr't,t t fruuru"[t"[nt ru nr r'l,ilyrounona:Jn0?y

^r^]--.n t .!" | ^ vultoltriooir.: rnnog:rit?uno r,ra"tnaoafiaLrnrdlutAu{ (crottis and

rrocal cordsl rrahq,lu* n,irlilavoo.rdlrruntrnrn,rru#u (Aerosol

and Humid if i er) fi r fluar r ur.r?o {n 1rfifl r#o l rlrf.: n.rr flier r uur r d"[r]oni.o

nr:r r nnfinilnen r#0il'ru3 r r.ru.ddo n,,oujrul , o , du.di. trn rr rnn. , fiu,!1l

fi r v ul u rt r 6ura r l'l o6 o fi u o r v iler r v i': i d u r riu r n nfi nrjao er r #o milff{ n r r i n rgr

n1lildrCI1firjrnr[u rua r t dorar er n1,ru ?h r fl u uir nr l ur r n do.: r r u"lun r r ra ru'l rul'','., ruuntre,u rf ': ,r'',ru.diilnrrfier,#uruorvr.m4r{r6uraru'lol[,]ur*i."lrt

"r^1^-^- 11. I --o_ x x f, ^ , ,u,,,, 4Iunlfflttailil1utuCI{0rnnrrqierttiotto.lrvuuil tilotfrertrnrrrn'tr'terurn 6rnrr

Y -. li't,vvAilO\: nUfi\: ttfl?IUUO

Feld and Bodey, 9.p.rji!, , p.1020.

Feld. and. Others, Cp. c j.:E. t p.99.

3Ki""hrr"r and Reheisr Op.cit.r p.597,

ANIn 1rRfl t.r01 c{ t yuLlilt y d1ylrtr?iln a 1..1

t, nlranr#u'lrrrrul tr',ri,du,1r^ur,lfnraud**u1r,;iru rfiuu 1 r1rlrror r fl urTqrara rriry r fli, 1v r fi r, J ruriun m, r 6onoo n'lua:ror ( rntracerebralHemorrhage),,rarrflu,rElrl,jrurfiufiiqr

1'I ! t vzurjrrfi'nm,rffrna, 1i,,ri ryjrur.ud, do rflulrnlafiErorr

orilaman ornrrarfrqdu'',]r.:1,,u1uia 6o firhror rfiouoonurnilrr:Jnfi tfi,rui,.,,:

,.nXjrudn + r,',rdu.irunr16*r#u) ?1nn1rnr1rr'.0n.*rj.*,auouun4 A 7tl ' l '1'rirrumfrur x:Jru"[:if,'lt ?,'rulurnir,tdontnrrryu eo,ooo/uu3 unyohu,:u

firlrrrfia zTglur3 ,(uzuunfid

z) fud + mrnrrfrnr,..,ijrr1rtr.,,[u fi.u*urnr,,rJ'4' a - t"te,rernmufiuluuar'14

r flonnrour'[u r rrli riouhr,r.rilt'ulr]1o.,rru rrfrfirurir..ruirtr - | H j o*'l"luiuq..:fiuriufi"l:rnr r 37.5" ,,orfi1ifio,lofruur4niu ird 1o n0{n1,

fini*ruiruf,li^u,,,^, r fion,y , duilu^uuodn r arJru,iu,6uu.,run1rff ,ur,,rrruur'(Meningitis 6 subarachnoid liemorrhage) ?1u1utnfo,t.iurt,*rrfu

ts,ooo/u:r3 fidnrfia tto luu3 rafr.:rrn"iiu1Jfrfiru; rfinr6or,,,rr ,

(rurrv coat) ,,a, rnf .r6on'riui*rirlinfla\: ,.rnrrfi'rlu6du iud 14rdl"

flo{n1t frnurzu:J':u t fiernrr; t 6oe'oon'lua:rot ( rntracerebral Hemorrhage)

rrnv tfiudiqr ?1u?urnin r6or,"lu{ri re,ooo/u:.r3 ua;fi.:1r,fr a zt6 luu3" '1 t x . .t. , '"LuXrjrunqilfrnr

I t fier t floralalo vtn r auo rn uu nfi r iurfiq un rlnurYu:,ru"l*1r]rjou,fnl9.O A -

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qnau"hlour.:rrn r f r uarorn:-Iqnrr 6rro,:,;jr, fiu, 6uruon,i,.,u,duo ran4 4 l- Y

t n inr r 6orrErhurrnen t,,r'1, r fi nnrr y,,r r nioudr uLu t 6o r 6oooo n.lutro.:

1rr.r*u=, Kaplan, and Armstrong, op. cit. t p.715.Copyright by Mahidol UniversityCopyright by Mahidol University

. .i I ' - J' v 't' ,ri vttat t ilo t frermurYunllt t fiouudilo':on r dufi d{ r a?urYut,rr'lu rril1il r fiufiiEr u:ro;r t ,---v o r^-...q1f i c. c^ - o X ta

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dltuanllflrufinhnq rilnerua vnuy (nera and others) r rurrufi.:iiru.a '

u, o ,l . oo o , - 'Ilt t t.t-l0uln tuc-o,tri tnUfrinlfn tfiOsrOOn ?1u?il 18 ,,tU ,Ttu1tfld1t1,10lu1?m

I4q41-lltaoenan luduornt 5 ,1u' rintul d'ntrrlflr il ou$ul rrarnur na11?1l,t'iul r nlafifl?1.r0rT,CIlafinnrrfi r doeraon rdo,:rttrn r nfn t danrrlou i.r,.,rrurninr6oerer]rrrj.,,,20,ooo - 5o,ooo/nn3 ryflrrdoeroonrdor,raoerrdonfin:rrnt.: lun-.- 4 |

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'r-1.4vil1nfl, r,t, tt0 tlJ01n''lf nO.: nttUerU

v- 7rl I4 , .{C 4 e A1ilfl1IrJl ilil1rjyl)J t a0n00nu, t,lut rriut1'

rlso|"a,))uu.l'.t't'"lunr r luanfrt uv d.l t liler1u r :]ufi.r fi r ? 11,1u1ii!rrro.l nu"io rrar'lunrr rrn"tsl nrufi'ufit

El c 4 a 1t 1' - vY I t 1'l Yl

n1tiurf,iiu:.rrn;flt6ogrrn:rruLr,asuhilr'luqlilrulflurirfran uurrmhu:.i1{r1u?,A A dl -v- j . - a, '"' o .lo

t ' ' ' 1o ",,tn0n11t te0fl00n tuo{urlvtdrnq tiluua"[u tdulilrr unr?,]1,1iJ1frilnrrey'[unrr

looi<4fl rta0u''t{ ila0ifi 1ilelildn rray I nu I nunl 1u dlrJ1, 0r1l I i --

tr'eId and 0thers, 9.prgij. r p.102.

)u a-ttytrx\t 0F1t"l{nt il 0utu1 [rn;mu-t, r -,I.v'^

t r0{ t fiulnu uu1[ flu1nu.

arraiunr16l*,,lurrnrrouuurGil.,r"[uo,]ru 2 r,)u r"fufi*, 1.,,,1-.-.-1r -- :r1.1 ^q..,1 le ,-.' u', u c A XTiu'tmm?0 Ttil1r t,d rflOurrarflur.l [u l:-LlUflu uil,:udn 1 ,1uiln1rfrertfroro.l

A q/. i ! o... r "t,r1.i t 6urTd,i1?, r ilo.r?1n rfrofirlfrrau,.r (Dipthcroia) uar'lururffuuirrfii'- ,A..1 I tl 9,, - L, !

1niuurilfrfi1uv'duu0? ilnn1, rurry r.{oornflnt,hrr nF..:qlarr,,nru,fiu6',.,n.',,rru,l-l

nir 105/rr. our.:'irfiqrrunrrfir,{offo r rfirflrfir,fiu1uqu,,r.,r,,ur"[,],flu

rTrgra.rl,nr r nu 1r0.r uirun,,1udfi n*.

,'vo1n 1r [rilrnto1J?1nnr16n tfio

: A ^ X 9' t o X q s + 40"1fl1t l.tlilr ll'dOuyl t n9t.]u Inrttn nrrqtntiio-lltnr y ttd lafrrrrta yn,]1yton

^r^.!- i .(, ^ x i x ^ e'

? 1nn lrqletteio fr't t iluuaq rnnt tfrnr u'fron lurLr I ru nrr rio r 6o'lun r y ua'[afrnyru- 7rl 1,, I vl ,

t, , v I"luurhu 3 r1u '[e,un ,,]rurrufi r rdofiq,.roru '[i,,n uou-d]u"lafin

arniillqrnonln nqrt6, 6.1n.'[n, r6urvrolr,*r*',,rur' (Non-irernorytic

Streptococci gr.D, E.Co1i, Enterobacter) ujrrr,',r,d , flr1?i,AlU

X 4 vi J t"

tEiotnauttanl ttavzu:hutrufi I nri?yllJrdanlulruud'lunryrrdlafiqr uon_--Z-., 1 --a- Xt " d; da __Ar o^,?lnuil'l tnnnl1vflOn?1nn1tfln ttorltifi?u tilor tnlryr,tii.,r:Io'i'uilnr raiu'lunrr

fl9rltoruttt..:tlu?utnnnllritntn"oouerqnnlllra1 n'nlrt rJofufrarrYq6'ur,ri]t 6oa s 4l Er ? v I I \ lt.

nrrvilrlnt',I tirt lnruzuilrurrufr 1 r vu!fifin rfio'iunr su6lafiflorurufif rrrflerI t ,"

0urr,i11{er1?ulru,,l1. - +g/uu3 turuu4fid 1) ljrumud z rrurufirlrrrfia!-U

:ro.,r,Yu 27 6 ^ loo /nu3 ( uuuf fld 2 ) ijrur rud r qrurufirJnrflaq.r q.

z+zluu3 1uiufi 2 r0,:n1rfinur rrnffuulrr*fil,]iil ,^.. 11 ;rdfinr.. ^J ) a d '(ttu1Jnilt,l 3) r{ tnru tartrorttnv tnornf 1d (crane, Emmer, and.

tru'GRGUras) nnrrr1 fl'rrafla.ir0{?fl1ufl':lnlfin rfluarrrqa.,ff}iiq.d*.1il{ |

^ X -l I I A s o I t .t du.:flon1rqtfi t tarru nyt t ,u t:to'.,rruruit,: [nr,leou r yu11\: 5oG-1ooo /ilur

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1.,,n,,rooY tr r tzotnrrfierrfro Joruzuilru 2 r1urfinnrrfinr#oornrroe,uruuay6n ., rru6rr#u) t/ ltrt t vorn tfrouudro':o"n rnr grrrufirfiernrrfinu#e"rurvuilr41,: r fiur,iru"louarrrrJUt-ilrvdrndrunnr..:ovfid'rrrrrrud.rj,4 :h,i'ur.,rynrrd : i.,,ri do,u.,,#uol"'s\: tn0t

,ttol"r''r:Slttrdnro,t (singer, Kaplan, and Armstrong)rru.r1u11rfioiir,rr'lr,izu:rrul,rf ,:rfiu6in.n.:qn6o,#.r. ,rou,,r.1f;,,ri ,6.t rr6utrnar nle,lluuauard.ln.'ln rrunrffi do , fiu : rfinraa.,,rfir iu!

d c o .....- o | | Y el Irtunil t rulrufllrnr]JaurlCIre]f ro:^rt_.t'iun4UEt":Orr,:yt'.r 3 ,lU x,rr, , ,,.,ud.rfi*,#u"[r,n, yun]afirrornaT erl'ur"ro,,u, ,'n6r,u^i. n,.,rfir,er,m*,],r;;;r.,

tt*r*'.,1rx,irurfiufiiqi rfiJ*ruori,nrifia (Kirchner ;rnd. Reheis)I 1/t I

,1u{1u11 ,,lrufifln'',rne,nirilrrfi'ui,.ru,i"lun.,rrudroolunrrfior#o Irfinrrfie,

rfio'lunrcudlnfin 6'qirflruo; rflu : r vir,o.rrrn65 rou rqy!1yxjrur,.,ud,r fie,nlrr6anrrn nr rfrer , fiur'.r*ru dolugjrrilrlor# , fiuo r, firn.,rfi. ,6u jru

4''4^o'nrJn11yfi0n o; rfrufriqra{fi..:rauns I o.ao6

1Crane, Emmer, and. GRGUras r !f,>. cit. , p.843.

I Pizza, Loc. cit.3__-E'eId and Bodey , J,oc. ci t .

a'tr'el-d and Others, Loc. cit.5-Kirchner ancl llehei s , Cp. ci t . t p.598 .6Feld. and Others, 0p.cit. r p,g9,Copyright by Mahidol UniversityCopyright by Mahidol University

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Lymphoma 105 ,1U.,' t_lulruet-!_U$q. flil ,, o,yrd ,(ilJl:lluu - finuruu t z5zz), so _ BT.

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