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目的:探讨近年来真菌性医院获得性肺炎发病的易患因素、临床特征、治疗及预后。方法:收集广州市第一人民医院2007年6月—2009年6月真菌性肺炎52例的临床资料,并对其分析。结果:92.7%真菌性医院获得性肺炎患者均患有较严重的基础疾病,87.8%患有两种或两种以上基础疾病,其中以慢性阻塞性肺疾病、肺炎、糖尿病、血液系统疾病多见,其易发因素为长期使用广谱抗生素、糖皮质激素及免疫抑制剂、气管插管/气管切开及呼吸机辅助通气、低蛋白血症,临床表现多不典型,痰培养以念珠菌最多,占61.5%,其中白色念珠菌占38.4%,且多合并革兰阴性菌感染,占51.9%。结论:真菌性医院获得性肺炎是多种疾病继发感染的重要原因,其临床表现不典型,病死率高,发病呈上升趋势,应引起临床高度重视。
Objective: To investigate the risk factors, clinical characteristics, treatment and prognosis of fungal hospital-acquired pneumonia in recent years. Methods: The clinical data of 52 cases of fungal pneumonia in Guangzhou First People’s Hospital from June 2007 to June 2009 were collected and analyzed. Results: 92.7% of patients with fungal hospital-acquired pneumonia had more serious underlying diseases, 87.8% had two or more underlying diseases, of which chronic obstructive pulmonary disease, pneumonia, diabetes and blood diseases were common , Its predisposing factors for long-term use of broad-spectrum antibiotics, glucocorticoids and immunosuppressive agents, tracheal intubation / tracheostomy and ventilator-assisted ventilation, hypoproteinemia, clinical manifestations and more atypical sputum culture with the largest number of Candida , Accounting for 61.5%, of which Candida albicans accounted for 38.4%, and multiple combined gram-negative bacteria infection, accounting for 51.9%. Conclusions: Fungal hospital-acquired pneumonia is an important cause of secondary infection of various diseases. Its clinical manifestations are not typical, its case fatality rate is high, its incidence is on the rise, which should be paid more attention in clinic.