ICU重症患者肺部真菌感染的临床分析

发布时间：2018-06-04 02:28

本文选题：重症监护病房 + 肺部感染　；参考：《中华医院感染学杂志》2014年04期

【摘要】：目的研究重症监护病房(ICU)患者肺部真菌感染的临床特点,为临床治疗提供参考。方法选取2011年1月-2013年1月ICU诊治的120例肺部真菌感染患者,回顾性分析其临床资料,总结患者的临床感染症状与体征、感染部位及真菌种类分布,并对引发肺部真菌感染的危险因素进行分析,采用SPSS16.0统计软件对数据进行处理,计量资料采用t检验,计数资料采用χ2检验。结果 120例ICU患者的症状与体征中以发热居多113例占94.17%,其次为肺部湿Up音63例占52.50%,痰量增多、黏稠61例占50.83%;经痰液、肺部分泌物及血液等标本中共分离出真菌133株,其中以白色假丝酵母菌为主78株占58.65%;其次为热带假丝酵母菌22株占16.54%、光滑假丝酵母菌14株占10.52%;长期应用糖皮质激素及免疫抑制剂、≥2种广谱高效抗菌药物应用1周、气管插管和气管切开、低蛋白血症、白细胞降低、入住ICU住院时间1周均为ICU患者并发肺部真菌感染的危险因素,其中≥2种广谱高效抗菌药物应用1周患者感染率最高,为64.17%。结论 ICU重症患者肺部真菌感染临床症状与体征主要是发热、肺部湿Up音、痰量增多黏稠,感染的真菌以白色假丝酵母菌居多,≥2种广谱高效抗菌药物应用1周是引发ICU患者肺部真菌感染的最主要危险因素。
[Abstract]:Objective to study the clinical characteristics of pulmonary fungal infection in the intensive care unit (ICU) and provide reference for clinical treatment. Methods 120 cases of pulmonary fungal infection were selected in January 2011, -2013, January, and the clinical data were analyzed retrospectively. The clinical infection symptoms and signs, infection sites and the distribution of fungal species were summarized. The risk factors of pulmonary fungal infection were analyzed, the data were processed by SPSS16.0 software, t test was used to test the data, and the count data was tested by chi 2 test. The results of 120 cases of ICU patients were 113 cases with fever in 94.17%, followed by 63 cases of wet Up in the lungs and 52.50%, and 61 cases of sticky and 61 cases accounted for 50.83%. 133 strains of fungi were isolated from sputum, lung secretions and blood samples, including 78 strains of Candida albicans, 22 of Candida tropicalis and 10.52% of Candida smooth, 14 strains of Candida smooth, and 10.52% with glucocorticoids and immunosuppressant, more than 2 kinds of broad-spectrum and efficient antibiotics used for 1 weeks, trachea for 1 weeks. Intubation and tracheotomy, hypoproteinemia, leukocyte reduction and 1 weeks of hospitalization for 1 weeks were the risk factors of pulmonary fungal infection in ICU patients, of which more than 2 kinds of broad-spectrum high-efficiency antibiotics were used for 1 weeks with the highest infection rate. The clinical symptoms and signs of pulmonary true bacteria infection in ICU severe patients were mainly fever and lung wet. Up sound, increased phlegm volume and thicker, infected fungi were mostly Candida albicans, and more than 2 broad-spectrum and efficient antibiotics used for 1 weeks were the most important risk factors for pulmonary fungal infection in ICU patients.
【作者单位】：青海大学附属医院急救中心;
【基金】：青海省卫生厅基金资助项目(QW-2010B-018)
【分类号】：R563.1

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