烧伤患者抗真菌药物的选择.pdfVIP

·专家论坛· 烧伤患者抗真菌药物的选择 郇京宁 of forburn HUAN Selection antifungalagents patients 功能低下以及其他高危因素诱 k◆，， BurnsandPlastic Hos— ring—ning．Departmentof Surgery，Ruijin 导下致病。白色念珠菌是烧伤 i”1德猕，f耖 Jiao School TongUniversityofMedicine，Shang- pital，Shanghai 患者最常见致病菌，其次是热 ：9 hai 200025，China isoneof 带念珠菌心o。近年来近平滑念珠菌、光滑念珠菌、克 infection theserious 【Abstract】Fungal compli- of burned with cations severely patientshighmortality．Applica— 柔念珠菌的检出率也有所上升。 tionof and is to timelyrationallyveryimportant antifungalagents 2．2致病性曲霉菌 controlthe infection．Antifungalagentsincludingpolyenes，tria— 致病性曲霉菌主要包括烟曲霉菌、黄曲霉菌和土 echinocandinshavebeenused inburned zoles，and widely pa— of tientsandare tobeeffective．Since fungal 曲霉菌等。曲霉菌孢子直径为2～5灿m，易悬浮在空 proved diagnosis infectionremains and therapies difficult，prophylacticempirical 气中。严重烧伤伴有气管切开者易吸入孢子引起肺 tobe orderto theeffi· appearparticularlynecessary．Inimprove 部曲霉菌病，曲霉菌孢子沉积在Ⅲ度烧伤创面、肌肉 of and of factors cacy safetyantifungalagents，the fungal andrenal 坏死组织或肉芽创面，可造成创面定植或感染。 strains，infection functions，andage， sites，hepatic etc．shouldbeconsideredinselectingantifungalagents． 2．3致病性接合菌 Burns； Anti—bacterial 【Keywords】 Fungi； agents 致病性接合菌中以毛霉菌致病最为常见。易感 【关键词】烧伤；真菌抗菌药