侵袭性肺部真菌感染的预防及治疗.docVIP

侵袭性肺部真菌感染的预防及治疗 西安市铁路中心医院呼吸内科 主治医师 1 马政权 710054 摘要：目的：探讨侵袭性肺部真菌感染(IFI)的预防及治疗。方法：对本院呼吸内科2005年初至2006年底共收治的819例患者中临床真菌感染的情况进行回顾性调查、分析。结果：发现真菌感染的检出率达全部痰检阳性的58.51%，而白色念珠菌的痰检阳性率达真菌感染中的76.71%。并有明显的高龄分布。结论：白色念珠菌为条件致病菌，易感者均为继发性肺部真菌感染。病因复杂多伴有或合并多种疾病。如，肺心病、呼吸衰竭、糖尿病、高血压、脑血管病后遗症、肺部肿瘤放、化疗后及长期应用糖皮质激素等。并且长期应用抗生素种类均达2种以上。我们可以从保护易感人群入手，对高危患者加强防护、监测并实施必要的经验性治疗。这将会有助于大大地减少肺部真菌感染的机会，提高治愈率，减少死亡率，缩短患者的住院时间，减少住院费用。 关键词：侵袭性肺部真菌感染；痰细菌培养；白色念珠菌 The Prevention and Treatment of Invasive Pulmonary Fungal Infection Ma Zheng-quan.( Department of Respiratory Medicine, Xian Railway Central Hospital, Xian 710054) Abstract: Aim: To investigate the invasive pulmonary fungal infection in the prevention and treatment. Methods: The beginning of 2005 to the end of 2006 patients admitted to our hospital 819 cases of respiratory medicine, clinical fungal infections were retrospectively analyzed. Results: The detection rate of fungal infection of the total smear-positive 58.51%, while the Candida albicans accounted for smear-positive rate of 76.71% fungal infections. A clear age distribution. Conclusion: Candida albicans as opportunistic pathogen, susceptible persons, who are secondary pulmonary fungal infection. Causes of complex multi accompanied by or merge a number of diseases. For example, pulmonary heart disease, respiratory failure, diabetes, hypertension, cerebrovascular disease complications, lung cancer radiotherapy and chemotherapy, and long-term use of glucocorticoid hormones. And the long-term use of antibiotics for more than two kinds of species each contributed. To protect susceptible populations from the start of the high-risk patients to enhance protection, monitoring and implement the necessary empirical therapy. This will help to significantly reduce pulmonary fungal infection, to improve the cure rate, reduce mortality and shorten hospital stays of patients and reduce hospital stay. Key words: Invasive pulmonary fungal infection; Sputum bacterial cultures; Candida albicans 引言 近30年来随着社会的