慢性重型肝炎患者侵袭性肺部真菌感染的CT影像学特征分析

发布时间：2018-05-30 03:47

本文选题：慢性重型肝炎 + 侵袭性肺部真菌感染　；参考：《中华医院感染学杂志》2016年11期

【摘要】：目的探讨慢性重型肝炎患者侵袭性肺部真菌感染的临床CT影像学特征,为慢性重型肝炎侵袭性肺部真菌感染患者临床诊治提供参考依据。方法选择医院2010年1月-2013年12月临床收治的慢性重型肝炎并发侵袭性肺部真菌感染患者114例为研究对象,根据患者临床治疗方法不同,将其分为对照组和研究组,每组各57例;对照组患者给予甘利欣、丹参注射液、促肝细胞生长素、血制品等常规治疗,研究组患者在对照组治疗的基础上采用氟康唑治疗,观察和比较两组患者病原菌分布特征及治疗前后CT影像学特征。结果 114例患者共检出病原菌218株,其中假丝酵母菌属93株、曲霉菌属75株及组织胞浆菌39株,分别占42.66%、34.40%及17.89%;治疗前,两组患者CT影像学特征分布率比较,差异无统计学意义,治疗后,研究组的CT影像学特征改善效果明显,患者出现CT影像学特征分布率明显低于对照组,差异有统计学意义(P0.05);治疗前CT平扫可见双肺多发斑片状密度增高影,边缘模糊,治疗后CT平扫显示,双肺病灶密度及范围较治疗前明显改善。结论慢性重型肝炎并发侵袭性肺部真菌感染患者的病原菌以假丝酵母菌属和曲霉菌属为主,患者的临床CT影像学特征主要表现为结节和磨玻璃影,患者给予氟康唑治疗后的临床效果较好。
[Abstract]:Objective to investigate the clinical CT imaging features of invasive pulmonary fungal infection in patients with chronic severe hepatitis, and to provide reference for the diagnosis and treatment of invasive pulmonary fungal infection in patients with chronic severe hepatitis. Methods 114 patients with chronic severe hepatitis complicated with invasive pulmonary fungal infection were selected from January 2010 to December 2013. According to the different clinical treatment methods, they were divided into control group and study group with 57 cases in each group. The patients in the control group were given routine treatment such as Glycyrrhizin, Salvia miltiorrhiza injection, hepatocyte growth promoting hormone, blood products, etc. The patients in the study group were treated with fluconazole on the basis of the treatment in the control group. To observe and compare the distribution of pathogenic bacteria and CT imaging features before and after treatment. Results 218 strains of pathogenic bacteria were detected in 114 patients, including 93 strains of Candida, 75 strains of Aspergillus and 39 strains of histiocytoplasma, accounting for 42.66% and 17.89%, respectively, before treatment, there was no significant difference in the distribution rate of CT imaging features between the two groups. After treatment, the CT imaging features of the study group were significantly improved, and the distribution rate of CT imaging features in the patients was significantly lower than that in the control group (P 0.05). After treatment, CT plain scan showed that the density and range of bilateral lung lesions were significantly improved compared with those before treatment. Conclusion the main pathogens of chronic severe hepatitis complicated with invasive pulmonary fungal infection are Candida and Aspergillus. The clinical effect of fluconazole was better than that of fluconazole.
【作者单位】：南阳医学高等专科学校医学技术系;南阳市中心医院CT室;南阳医学高等专科学校第一附属医院急诊科;南阳医学高等专科学校第一附属医院妇产科;南阳医学高等专科学校第一附属医院检验科;
【基金】：河南省医学教育研究基金资助项目(Wjlx2015128)
【分类号】：R519;R575.1

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