重症监护病房患者肺部真菌感染的临床分析及相关危险因素研究

发布时间：2018-01-29 22:52

  本文关键词： 重症监护病房 肺部真菌感染 危险因素　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的统计重症监护病房患者真菌感染的相关危险因素,探讨重症监护病房(ICU)患者肺部真菌感染的临床特点及相关危险因素,寻找预防肺部真菌感染的对策。方法回顾性分析2014年4月~2016年7月我院116例ICU肺部真菌感染患者临床资料,并选择同期入住ICU非真菌感染重症肺炎患者110例作为对照组,数据采用SPSS 17.0统计软件进行处理。结果ICU肺部真菌感染患者感染的症状、体征主要包括肺部湿Up音、发热与痰量增多、黏稠等,其中以发热为主;经检查共分离出126株真菌,其中真菌主要有光滑假丝酵母菌13株,热带假丝酵母菌21株,白色假丝酵母菌76株等;通过统计学推断,引起肺部真菌感染的相关危险因素主要有入住ICU时间1周、白细胞小于4×109/L、低蛋白血症、气管插管与气管切开、长期使用免疫抑制剂与糖皮质激素、灌肠后大便3日未解、应用≥2种广谱高效抗菌药物时间1周等。其中应用≥2种广谱高效抗菌药物时间1周、灌肠后大便3日未解、低蛋白血症、留置静脉导管1周是独立危险因素。结论ICU肺部真菌感染患者的症状、体征以发热为主,真菌感染类型以白色假丝酵母菌最多,应用≥2种广谱高效抗菌药物时间1周、灌肠后大便3日未解、低蛋白血症、留置静脉导管1周是独立危险因素。
[Abstract]:Objective to analyze the risk factors of fungal infection in patients in intensive care unit (ICU), and to explore the clinical characteristics and related risk factors of fungal infection in lung of patients with ICU in intensive care unit (ICU). Methods the clinical data of 116 ICU patients with pulmonary fungal infection from April 2014 to July 2016 were retrospectively analyzed. 110 cases of severe pneumonia with ICU nonfungal infection were selected as control group. Results the symptoms and signs of pulmonary fungal infection in patients with ICU were mainly including lung wet up sound, fever and sputum volume increase, viscous and so on. Among them, fever is the main; A total of 126 fungi were isolated, of which 13 were Candida smooth, 21 were Candida tropicalis and 76 were Candida albicans. According to statistical analysis, the main risk factors for pulmonary fungal infection were ICU stay for 1 week, leukocyte less than 4 脳 109 / L, hypoproteinemia, tracheal intubation and tracheotomy. Immunosuppressive agents and glucocorticoids were used for a long time. After enema, defecation was not solved on 3rd, and the time of application of more than 2 broad-spectrum high effective antibiotics was 1 week, in which 鈮，

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