论文部分内容阅读
目的探讨老年慢性支气管炎合并真菌感染患者临床资料、病原菌分布及诱发真菌感染的相关因素,为临床诊断治疗提供可靠依据。方法选取2011年12月-2015年9月医院收治的慢性支气管炎老年患者769例为研究对象,收集相关的临床资料,对感染患者的送检标本进行真菌培养和药敏试验,统计患者真菌感染率、感染部位、病原菌分布,分析真菌感染的相关因素及抗真菌治疗效果;采用SPSS19.0软件进行统计分析。结果 769例老年慢性支气管炎中合并真菌感染34例,感染率为4.42%;感染部位以肺部最常见,占52.94%,其次为泌尿道和肠道,分别占20.59%和14.71%;共分离出真菌49株,其中白色假丝酵母菌30株占61.23%,热带假丝酵母菌7株占14.29%,两者共占总菌数的75.52%;年龄、吸烟史、糖尿病史、侵入性操作、抗菌药物的使用时间及种类是慢性支气管炎合并真菌感染的影响因素;经治疗后,痊愈13例占8.24%,显效10例占29.41%,进步7例占20.59%,无效4例占11.76%;总有效率为67.75%。结论老年慢性支气管炎合并真菌感染以肺部组织最常见,致病真菌以白色假丝酵母菌为主,治疗中应重视年龄、吸烟史、糖尿病史、侵入性操作、抗菌药物的使用时间及种类等相关影响因素,采取积极治疗措施,提高治愈率。
Objective To investigate the clinical data, the distribution of pathogens and the related factors of fungal infection in elderly patients with chronic bronchitis complicated with fungal infection and provide a reliable basis for clinical diagnosis and treatment. Methods A total of 769 elderly patients with chronic bronchitis admitted from December 2011 to September 2015 in our hospital were enrolled in this study. Relevant clinical data were collected. Fungal culture and drug susceptibility tests were performed on the specimens from infected patients. Fungal infections Rate, infection site, distribution of pathogens, analysis of fungal infection related factors and antifungal treatment effect; using SPSS19.0 software for statistical analysis. Results Among the 769 elderly patients with chronic bronchitis, 34 cases were complicated with fungal infection, the infection rate was 4.42%. The lungs were most common in the infected sites, accounting for 52.94%, followed by the urinary tract and intestine, accounting for 20.59% and 14.71% respectively. Among them, 49 were fungi, of which Candida albicans accounted for 61.23%, Candida tropicalis 7 strains accounted for 14.29%, accounting for 75.52% of the total number of bacteria; age, smoking history, history of diabetes, invasive procedure , The time and type of antibacterials used were the influencing factors of chronic bronchitis complicated with fungal infection. After treatment, 13 cases were cured, 8.24% were cured, 10 cases were markedly effective, 29.41% were improved, 7 cases were advanced, 20.59% were improved, 4 cases were ineffective, accounting for 11.76% The total effective rate was 67.75%. CONCLUSION: Pulmonary tissue is the most common pathogenic fungal infection in elderly patients with chronic bronchitis. Pathogenic fungi are mainly Candida albicans. Age, smoking history, history of diabetes mellitus, invasive procedures, time and type of antibacterial use should be emphasized And other related factors, take active treatment measures to improve the cure rate.