医院肺部真菌感染临床病例荟萃分析.docx 全文免费在线阅读

  本文关键词：医院肺部真菌感染临床病例荟萃分析，由笔耕文化传播整理发布。

网友你是我的全部近日为您收集整理了关于医院肺部真菌感染临床病例荟萃分析的文档，希望对您的工作和学习有所帮助。以下是文档介绍：南昌大学医学院硕士学位论文医院肺部真菌感染临床病例荟萃分析姓名:陈刚申请学位级别:硕士专业:内科学指导教师:颜春松20070515摘要摘要目的了解国内近十年来医院肺部真菌感染(PFIH)诊治等方面的研究现状,以提高临床诊治水平。方法检索我国1996---,2006年核心期刊发表的PFIH临床病例分析结果进行汇总、归纳和统计分析。结果共检索到文献60篇,其中19篇(病例总数1201例)进入荟萃分析。PFIH的发生率约为0.7%,PFIH占同期下呼吸道感染的5.1%,ICU中PFIH发生率为7.8%;易感因素分析显示长期使用抗生素、长期使用糖皮质激素、住院时间长(>3周)、接受放、化疗、呼吸道侵入性操作等与PFIH有关,有显著统计学意义(与对照组比较P<0.01);基础疾病分析显示呼吸系统疾病占65.26%,其中又以COPD占首位:ICU病例中,颅脑外伤(含术后)占55.69%;临床表现分析显示无特异性;国内的PFIH诊断标准大多以卫生部2001年颁布的医院感染诊断标准(试行)为基础:病原学分析显示念珠菌占84.78%,其中又以白色念珠菌占首位;病原学诊断方法显示我国仍主要依靠痰液培养,而采取肺组织学检查诊断者极少;治疗以***康唑为主;PFIH死亡率为11.7%,ICU中PFIH患者死亡率高达36.7%。结论PFIH其临床表现特异性少,病死率高,基础疾病以呼吸系统疾病为主,易感因素包括长期使用抗生素、长期使用糖皮质激素、长时间住院、接受放、化疗、呼吸道侵入性操作等;国内的病原学多以痰培养作为诊断依据,诊断标准不太一致,与国外以及国内颁布的最新诊治指南存在一定的差距,有待于进一步改进和规范。关键词肺;真菌感染;荟萃分析IIAbstractABSTRACTObjective Obtainingan objective and integratedunderstanding of Chinesediagnoseand treatment status with pulmonary fungal infections in hospital(PFIH)inthis ten years,to guide clinical practice.MethodsUse Meta-analysis to conclude clinical articles about PFIH retrievallingin the period from 1 996 to 2006.Results60 articles were identified,1 9articles(total cases1 201)were selected forMeta-analysis.The general incidence ofPFIH iS 0.7%.It accounts5.1%inlowerrespiratory infection in hospitalized patientswith the same period,and accounts7.8%in ICU patients.Data for me predisposingfactoranalysis demonstrates use of broadspectrum antibioticsand/or steroids overalong period,length of stayover3 weeks,experiencing radiotherapyor chemotherapy,invasivemanipulation with respiratorytract to be statistical significance(vs control group,P<O.01).Data for the predisposingdisease analysis demonstrates that disease of respiratory ounts 65.26%oftotal cases,among them,COPD is in the first place;In ICU cases,craniocerebraltrauma accounts 55.69%.The clinicalmanifestation of PFIHis not specific.Data forfungi separationanalysis demonstrates Candida was ranked thefirstpathogen(84.78%),among them,Candida albicans is the main pathogen.Aetiologydiagnosticmethod demonstrates it dependson sputum culture in major,and adopts histologytodiagnose is few.Data for mortalityanalysis demonstrates the general mortality ofPFIH is about 11.7%.but in ICU patients it iS to 36.7%.ConclusionsThe clinical features of PFIH iS non—specific,the morbidity isrising.Disease of respiratory system is the main predisposing disease.The predisposingfactor includeuse of broad spectrumantibioticsand/or steroids overalong period,hospitalizationoveralong period,experiencing radiotherapyor chemotherapy,invasive manipulationwith respiratory tract.The aetiologydiagnosis mainly dependson sputum culture.Thediagnostic criteria of domestic isdiscordant,and there iS pare with latest diagnosisand treatment guide of domestic and overseas,it iS time to improve and standard step by step asSOOIl as possible.KeyWordsLung;Fungalinfection;Meta-analysis.III缩略词缩略词1、PFIH(Pulmonary Fungal Infections inHospital):医院肺部真菌感染2、IFI(Invasive Funga

12>

  本文关键词：医院肺部真菌感染临床病例荟萃分析，由笔耕文化传播整理发布。