重症监护室慢性阻塞性肺病患者并发真菌感染高危因素研究.docVIP

重症监护室慢性阻塞性肺病患者并发真菌感染高危因素研究【摘要】 目的 探讨重症监护室慢性阻塞性肺病患者并发真菌感染的高危因素。方法 2010年1月至2011年3月重症监护室COPD急性加重期发生真菌感染36例(真菌感染组)，随机选取同期住院的COPD急性加重期未发生真菌感染(非真菌感染组)56例，对真菌感染组进行感染部位、感染真菌种类进行统计并计算构成。观察真菌感染组与非真菌感染组高危因素进行对比分析。结果 并发真菌感染的高危因素为年龄、营养状况、糖尿病、使用有创呼吸机、抗生素应用、糖皮质激素应用等因素。结论 慢性阻塞性肺病应合理使用抗生素及糖皮质激素，减少不必要的侵袭性检查治疗，加强营养支持.改善胃肠道微生物环境，严密监测以预防医源性感染。 【关键词】 慢性阻塞性肺病；并发真菌感染；高危因素 The risk factors of intensive care unit patients with chronic obstructive pulmonary disease and fungal infection ZHANG De?zhen. Shangqiu City, First People?s Hospital of Shangqiu City ,Shangqiu,476100,China 【Abstract】 Objective To investigate risk factors of the intensive care unit patients with chronic obstructive pulmonary disease and fungal infection.Methods From January 2010 to March 2011,intensive care unit with acute exacerbation of COPD fungal infection in 36 patients (fungal infection), randomly selected over the same period of acute exacerbation of COPD hospitalization was no fungal infection (fungal infection of non?group).56 cases of fungal infection group of infection, fungal infection and type of statistical calculation form. Observed fungal infection group and non?fungal infection risk factors were analyzed. Results The fungal infection risk factors was age, nutritional status, diabetes, use of invasive ventilation, antibiotics, corticosteroids applied and other factors. Conclusion Chronic obstructive pulmonary disease should be rational use of antibiotics and corticosteroids. Reduce unnecessary invasive examination and treatment, nutrition support. Improve gastrointestinal microbial environment, close monitoring to prevent iatrogenic infections. 【Key words】 Chronic obstructive pulmonary disease; Fungal infections;Risk factors 慢性阻塞性肺疾病(COPD)是内科呼吸系统慢性疾病.为内科常见病，是一种具有气道受限特征的的疾病，气流受限不完全可逆，通常呈进行性发展间断加重为特点。由于病程 作者单位：476100河南省商丘市第一人民医院 较长患者发作时病情危重，多需进行重症监护。近年来深部 真菌感染率呈持续上升趋势，肺部真菌感染居所有内脏真菌感染的首位，占院内获得性肺炎的10％~15％，以慢性阻塞性肺疾病多见［1］。为了能够减少慢性阻塞性肺病患者并发真菌感染，我们对其高危因素进行分析，现汇报如下。 1 资料与方法 1.1 一般资料