急诊ICU肺部侵袭性真菌感染危险因素分析

发布时间：2018-06-06 22:34

本文选题：急诊重症监护病房 + 侵袭性真菌感染　；参考：《新疆医科大学》2012年硕士论文

【摘要】：目的：对我院急诊科重症监护病房患者肺部侵袭性真菌感染的高危因素进行分析，以明确哪些致真菌感染的危险因素为急诊重症监护病房患者肺部侵袭性真菌感染的独立危险因素，以采取积极有效的预防控制措施。方法：采用回顾性调查研究的方法，对我院急诊科重症监护病房2010年1月至2011年12月收住35例确诊为肺部侵袭性真菌感染的患者的临床病历资料进行分析，，并抽取同期在我院急诊科重症监护病房住院的35例发生肺部细菌感染但未合并真菌感染患者的临床病历资料，对两组患者的病历资料进行对比，并对可能导致患者肺部侵袭性真菌感染的15项指标进行单因素及logistic多重回归分析，最后筛选出侵袭性真菌感染的独立危险因素。结果：对15项侵袭性真菌感染潜在的危险因素进行单因素分析后，得出合并糖尿病、深静脉置管、广谱抗生素的应用时间＞2周、广谱抗生素应用种类＞2种、糖皮质激素的应用是肺部侵袭性真菌感染的危险因素，再进行Logistic多因素回归分析后，最后只有合并糖尿病、深静脉置管、广谱抗生素的应用时间＞2周及广谱抗生素应用种类＞2种是肺部侵袭性真菌感染的独立危险因素。结论：在急诊科重症监护病房，对存在侵袭性真菌感染高危因素的患者应加强病原菌监测，并适当采取预防措施，达到控制真菌感染的目的。
[Abstract]:Objective: to analyze the risk factors of invasive fungal infection in the patients in the intensive care unit of the emergency department of our hospital, so as to identify the risk factors for fungal infection in the emergency intensive care unit (ICU) as an independent risk factor for the invasive fungal infection of the lung in the emergency intensive care unit, and to adopt a positive and effective preventive and control measure. The clinical data of 35 cases of pulmonary invasive fungal infection in the intensive care unit of the emergency department of our hospital from January 2010 to December 2011 were analyzed by sex investigation and study, and 35 cases of pulmonary bacterial infection in the emergency department of our hospital during the same period were taken from the patients with pulmonary infection but not with fungal infection. Clinical records were compared for two groups of patients, and single factor and logistic multiple regression analysis were performed on 15 indicators that might lead to invasive fungal infection in the patients. Finally, independent risk factors for invasive fungal infection were screened. Results: the potential risk factors for 15 invasive fungal infections were given. After the analysis of the factors, we found that the combination of diabetes, deep venous catheterization, broad spectrum antibiotic application time > 2 weeks, broad spectrum antibiotic application species > 2 species, the application of glucocorticoid is the risk factor of pulmonary invasive fungal infection, and then after Logistic multiple regression analysis, the last only combined diabetes, deep venous catheterization, broad-spectrum antibiotics. The application time > 2 weeks and the wide spectrum antibiotic application species > 2 are independent risk factors for the pulmonary invasive fungal infection. Conclusion: in the emergency intensive care unit, the patients with high risk factors for invasive fungal infection should be monitored and the prevention measures should be taken to achieve the purpose of controlling the fungal infection.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R519

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