75例深部霉菌感染尸体解剖及临床分析

Autoptical and Clinical Analysis on 75 Cases of Deeper Fungi Infection

本文报告自1954年4月至1991年4月,我院尸检证实为真菌感染75例,占尸检人数2.7％。80年代较60年代检出率增多2.2倍。本组病例原发病最多为恶性肿瘤,特别是白血病及恶性淋巴瘤,其次为肝硬化,免疫性疾病,心血管疾病及创伤。霉菌感染与上述疾病治疗过程中,应用化疗、放疗、免疫抑制剂、肾上腺皮质激素及联合应用抗生素密切相关。真菌种类,本组以曲菌占首位(46人次),其次为念球菌(29人次),新型隐球菌(6人次),毛霉菌(5人次)。生前明确诊断共13例;占17.3％,说明临床医生对本病认识不足。文中简述了上述四种霉菌的特征,以助予早期诊断及治疗。并提出对霉菌感染预防的重要性。加强医院管理,严格掌握抗生素使用范围,以及对患者的环境保护是预防深部霉菌感染的主要环节。

75 cases of deeper fungi infection, all confirmed by autopsy from 1954 to 1991, were reported. The in- fection was found in 2.7 per cent of autopsied patients, among which the incidence was 2.2 times higher in 1980s than that of 1960s. The original disease were mainly malignant tumor, especially leukemia and lymphoma. Others were liver cirrhosis, immune-relat- ed disease, cardiovascular disease, trauma etc. Fungi infection was closely related to chemotherapy, radiotherapy, immunosupressive drugs, corticoid and antibiotics used in the treatment of diseases mentioned above. Aspergilli was found to be the most common form of fungi (53.49%). Monilia, the second (33.72%). The rests were cryptococcus neoformans (6.98%) and mucor (5.81%). Only 13 patiants were diagnosed clinically. This means the cliniciens were not aware of the importance of fungi infection. The characteristics of various forms of fungi, the importance and meas- ures of prevention were also discussed.