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目的探讨用氟康唑预防重症急性胰腺炎(SAP)合并真菌感染的效果。方法将 1998年7月至2004年6月收治的SAP并存真菌感染易感因素79例患者随机分预防组和对照组, 预防组在常规治疗的基础上加每日静脉点滴氟康唑200 mg,对照组仅给予常规治疗;观察两组患者的真菌感染的发生率、发生时间、抗真菌治疗后的真菌清除率和因真菌感染的死亡率,两组患者的住院时间。结果预防组的真菌感染率(5．3％:27．5％,P<0．05),因真菌感染的死亡率 (5．1％:12．5％,P<0．05),住院时间(38．3:57．4,P<0．05)均明显低于对照组,但预防组发生真菌感染后抗真菌治疗的真菌清除率低(33％:72．7％,P<0．05)。结论氟康唑能有效降低SAP合并真菌易感因素患者的真菌感染发生率和死亡率,缩短住院时间。
Objective To investigate the efficacy of fluconazole in preventing severe acute pancreatitis (SAP) complicated with fungal infection. Methods From July 1998 to June 2004, 79 patients with susceptible factors of SAP co-morbid fungal infection were randomly divided into prevention group and control group. On the basis of routine treatment, prophylactic group was given daily intravenous infusion of fluconazole 200 mg, The control group was given routine treatment only. The incidence of fungal infection, the time of onset of fungal infection, the fungal clearance rate after antifungal therapy and the mortality rate due to fungal infection were observed in two groups. The hospitalization duration was compared between the two groups. Results The fungal infection rate in the prophylaxis group (5.3% vs 27.5%, P <0.05) was significantly lower for the fungal infection (5.1% vs 12.5%, P <0.05) Time (38.3: 57.4, P <0.05) were significantly lower than the control group, but fungal antifungal therapy in the prophylaxis group had a low rate of fungal elimination (33% vs 72.7%, P <0 .05). Conclusion Fluconazole can effectively reduce the incidence of fungal infection and mortality in SAP patients with fungal susceptibility factors and shorten the hospital stay.