上颈椎损伤患者深部真菌感染流行病学调查

Epidemic investigation of fungus infection in patients with upper cervical trauma

目的 对上颈椎损伤合并真菌感染患者进行回顾性分析 ,探讨其临床特点及其抗真菌治疗对预后的影响。方法 2 0 0 0年 1月至 2 0 0 2年 12月共收治上颈椎损伤患者 336例 ,其中 38例合并真菌感染 ,比较真菌感染与非真菌感染这两组患者的一般情况、抗生素应用情况、真菌感染部位和感染菌种、抗真菌疗效及两组患者死亡率。结果 真菌感染发生率为 11.31% ,真菌感染组患者病死率 39.4 7% ,非真菌感染组患者病死率 18.12 % ,两组比较存在显著性差异 (P <0 .0 1)。感染菌种以白色念珠菌和热带念珠菌居多 ,感染部位主要集中在呼吸道及泌尿道 ,抗真菌治疗总有效率为 6 0 .5 3%。结论 上颈椎损伤合并深部真菌感染患者病死率明显升高 ,应及时开展早期经验性抗真菌治疗 ,选择有效的抗真菌药物 ,以期降低患者的病死率。

Objective Investigate fungus infection in the patients with upper cervical trauma. Analysis the data of clinic characteristics and the prognostic of antifungus treatment. Method 336 cases with upper cervical trauma from 2000 Jan to 2001 Dec were discussed, and of which 38 cases have the fungus infection. The results of fungus' infection, classification and mortality were compared. Results The incidence of fungus infection is 11.31%.The mortality of patients with fungus infection is 39.47% which is evidently higher than that in patients with nonfungus infection. Candidia albicans and Candidia tropicalis appears to be the main fungus of infection and also with the Respiratory tract and Urinary tract were main infection position .The general efficiency of antifungus treatment is 60.53%. Conclusions The mortality in upper cervical trauma patients with fungus infection is evidently higher than usual. Treatment of AntiFungus with Early Experience should be given with the effect drug for the patients so as to lower the mortality.