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目的探讨慢性阻塞性肺疾病急性加重期(acute exacerbation chronic obstructive pulmonary disease,AECOPD)肺部真菌感染的临床特点、相关因素及疗效。方法回顾性分析了2008年1月至2009年12月间AECOPD院内继发肺部真菌感染患者46例,并随机抽取相同时期无真菌感染的AECOPD患者46例作对比分析。结果 AECOPD院内继发肺部真菌感染患者临床表现无特异性,病原菌以白色念珠菌为主。长期使用广谱高效抗生素和糖皮质激素、低蛋白血症、合并糖尿病以及机械通气是AECOPD院内继发真菌感染的主要危险因素。结论合理正确使用抗生素及糖皮质激素,预防医源性感染,加强营养,尽量缩短住院天数是降低AECOPD院内继发真菌感染发生率的关键因素。
Objective To investigate the clinical features, related factors and therapeutic effects of pulmonary fungal infection in patients with chronic exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A retrospective analysis of 46 patients with secondary fungal pulmonary infection in AECOPD hospital between January 2008 and December 2009 and 46 patients with AECOPD without fungal infection were randomly selected for comparison. Results AECOPD hospital secondary pulmonary fungal infection in patients with nonspecific clinical manifestations of Candida albicans-based pathogens. Long-term use of broad-spectrum antibiotics and glucocorticoids, hypoproteinemia, diabetes mellitus and mechanical ventilation are the main risk factors for secondary fungal infections in the AECOPD hospital. Conclusion Reasonable and proper use of antibiotics and glucocorticoids, prevention of iatrogenic infection, enhancement of nutrition and shortening the length of hospital stay are the key factors to reduce the incidence of secondary fungal infections in AECOPD hospital.