慢性重症肝炎患者真菌肺部感染的CT影像特征分析

发布时间：2018-03-24 15:39

本文选题：慢性重型肝炎　切入点：侵袭性肺真菌感染　出处：《中华医院感染学杂志》2015年07期

【摘要】：目的研究慢性重型肝炎并发侵袭性肺部真菌感染患者的CT特点,为合理选用抗菌药物预防控制并发感染提供依据。方法选取2010年3月-2013年12月进行治疗的慢性重型肝炎并发侵袭性肺真菌感染的94例患者为研究对象,随机分为两组,各47例;对照组患者采用常规治疗措施,试验组患者采用氟康唑治疗,根据CT检查结果,回顾性分析两组患者的病变和病原菌分布。结果治疗前,对照组真菌培养结果显示假丝酵母菌属占44.58%、曲霉菌属占27.71%、组织胞浆菌占21.69%、其他真菌占6.02%,试验组假丝酵母菌属占43.96%、曲霉菌属占42.86%、组织胞浆菌占15.38%、其他真菌占4.40%,两组患者治疗前的病原菌分布状况基本相同,经比较差异无统计学意义;治疗前,对照组患者CT结果表现为结节占40.42%、磨玻璃影占27.66%、网格或线样占21.28%、胸腔积液占10.64%;试验组CT结果中总显效率结节占36.17%、磨玻璃影占31.92%、网格或线样占25.53%、胸腔积液占6.38%。结论慢性重型肝炎并发侵袭性肺真菌感染患者多以假丝酵母菌属和曲霉菌属较为常见;合理使用氟康唑治疗慢性重型肝炎并发侵袭性肺真菌感染疗效确切;患者CT主要表现为结节和磨玻璃影,但无特异性,需结合临床资料做出准确判断。
[Abstract]:Objective to study the chronic severe hepatitis complicated with CT in patients with pulmonary fungal infection, for the rational use of antimicrobial drugs provide the basis for preventing and controlling infection. Methods from March 2010 -2013 year in December for treatment of chronic severe hepatitis complicated with invasive pulmonary fungal infection in 94 cases of patients as the research object, randomly divided into two groups, 47 cases in each; the control group was treated with conventional treatment, the experimental group was treated with fluconazole treatment, according to the result of CT examination, retrospective analysis of pathological changes and distribution of pathogens in the patients of the two groups. Results before treatment, the control group of fungal culture results showed that Candida Aspergillus accounted for 44.58%, accounting for 27.71%, histoplasmosis accounted for 21.69%, other fungi accounted for 6.02%, the experimental group of Candida Aspergillus accounted for 43.96%, accounting for 42.86%, histoplasmosis accounted for 15.38%, fungi accounted for 4.40%, the distribution of pathogenic bacteria of two groups of patients before treatment. The situation is basically the same, the difference was not statistically significant; before the treatment, the patients in the control group CT results showed nodules accounted for 40.42%, accounting for 27.66% of ground glass shadow, grid or line like pleural effusion accounted for 21.28%, accounting for 10.64%; the test group CT results in the total effective nodules accounted for 36.17%, accounting for 31.92% of ground glass shadow, grid or line the sample accounted for 25.53%, accounting for pleural effusion 6.38%. conclusion with chronic severe hepatitis patients with invasive Candida and Aspergillus species are common pulmonary fungal infection; rational use of fluconazole in the treatment of chronic severe hepatitis complicated with invasive pulmonary fungal infection curative effect; patients with CT showed nodules and ground glass opacity, but no specific. Combined with clinical data to make accurate judgments.

【作者单位】：宁波市第二医院放射科;
【基金】：浙江省卫生厅基金资助项目(ZW-2010B-031)
【分类号】：R575.1;R519;R816.41

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