105例侵袭性真菌感染患者临床分析

发布时间：2018-04-08 08:24

本文选题：侵袭性真菌感染　切入点：真菌　出处：《中华医院感染学杂志》2016年21期

【摘要】：目的分析105例侵袭性真菌感染(IFI)患者的病原菌和临床特征,为临床诊断和治疗提供借鉴。方法采用回顾性病例分析的方法,收集2011年1月-2014年12月医院门诊和住院IFI患者的病例资料,纳入标准为经活检组织病理学检查确诊。结果 92.4%病例为院外获得性感染,52.4%病例无IFI危险因素,手术取材、CT引导下穿刺和内镜下活检是主要的确诊手段,IFI病原菌以曲霉为主占54.3%,其次为毛霉占8.6%、隐球菌占4.8%和假丝酵母菌占3.8%;33.3%IFI病例伴有肺部侵犯,但胸部影像学和临床表现的特征性不强;73.3%病例经手术清除病灶,26.7%病例使用抗真菌药物治疗,其中6例接受手术和抗真菌联合治疗;7例死亡或治疗无效。结论积极开展有创性检查、早期诊断、手术清除病灶和针对性抗真菌治疗可以降低IFI患者的病死率。
[Abstract]:Objective to analyze the pathogenic bacteria and clinical features of 105 patients with invasive fungal infection (IFI) and to provide reference for clinical diagnosis and treatment.Methods retrospective case analysis was used to collect the data of outpatient and inpatient IFI patients from January 2011 to December 2014. The included criteria were confirmed by biopsy histopathological examination.Results 92.4% of the cases had no IFI risk factors, 52.4% had nosocomial infection.CT-guided puncture and endoscopic biopsy were the main means of diagnosis. Aspergillus was the main pathogen, Mucor was 8.6. Cryptococcus was 4.8% and Candida cerevisiae was 3.83.33.3 IFI cases with pulmonary invasion.However, 73.3% of the chest imaging and clinical manifestations were characterized by debridement. 26.7% of the cases were treated with antifungal drugs. Among them, 6 cases received combined operation and antifungal therapy. 7 cases died or failed in the treatment.Conclusion aggressive examination, early diagnosis, surgical debridement and targeted antifungal therapy can reduce the mortality of IFI patients.
【作者单位】：南方医科大学珠江医院重症医学科;东莞市厚街医院急诊科;兴宁市人民医院重症医学科;
【基金】：广东省省级科技计划项目(2014A020212670)
【分类号】：R519

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