ICU呼吸机相关性肺炎患者痰液真菌阳性的临床研究

发布时间：2018-06-15 05:42

本文选题：呼吸机相关性肺炎 + 真菌　；参考：《中华医院感染学杂志》2015年16期

【摘要】：目的研究综合重症监护病房(ICU)中临床诊断为呼吸机相关性肺炎(VAP)患者痰液培养真菌阳性在VAP患者中的临床意义,为合理使用抗菌药物提供参考依据。方法选择2012年4月-2014年4月ICU临床诊断为呼吸机相关性肺炎的142例患者为研究对象,按痰培养结果分为真菌阳性组77例和真菌阴性组65例,比较两组患者的通气时间及病死率等,数据采用SPSS 13.0软件进行统计分析。结果 142例患者共培养出病原菌394株,其中真菌检出126株,占32.0%;在142例临床诊断的VAP患者中真菌阳性77例占54.2%;患者真菌感染与其年龄及伴有呼吸系统疾病相关(P0.05);真菌阳性组及真菌阴性组患者的机械通气时间分别为(363±85)h和(300±67)h,患者病死率分别为39.0%、43.1%,两组间差异无统计学意义。结论呼吸机相关性肺炎患者痰培养真菌阳性率高,与其年龄及伴有呼吸系统疾病相关。
[Abstract]:Objective to study the clinical significance of positive sputum culture fungi in patients with VAP diagnosed as ventilator associated pneumonia (VAP) in integrated intensive care unit (ICU), and to provide reference for rational use of antimicrobial agents. Methods 142 patients with ventilator-associated pneumonia diagnosed in ICU from April 2012 to April 2014 were selected as subjects. According to the results of sputum culture, 77 patients were divided into fungal positive group (77 cases) and fungal negative group (65 cases). The ventilation time and mortality were compared between the two groups. The data were analyzed by SPSS 13.0 software. Results A total of 394 strains of pathogenic bacteria were cultured in 142 patients, among which 126 strains were detected by fungi. Of 142 patients with VAP diagnosed clinically, 77 were fungal positive (54.2%), the fungal infection was associated with age and respiratory diseases (P0.05), and the mechanical ventilation time of fungal positive and fungal negative VAP patients were 363 卤85 hours and 300 卤67 hours, respectively. The mortality was 39.0% and 43.1%, respectively. There was no significant difference between the two groups. Conclusion the positive rate of sputum culture fungi in patients with ventilator-associated pneumonia is high, which is related to their age and respiratory diseases.
【作者单位】：华中科技大学同济医学附属同济医院ICU;
【基金】：湖北省自然科学基金资助项目(2014CFB962)
【分类号】：R563.1

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