慢性支气管炎继发医院内真菌感染的临床和治疗经济学分析

Analyses of the Clinical Treatment of Inpatients with Chronic Bronchitis Complicated by Mycotic Infection, with an Impact on Pharmaco-economics

目的分析慢性支气管炎继发医院内深部真菌感染的临床及治疗经济学情况.方法查阅2003年9月～2004年4月慢性支气管炎患者126例的病历,对其抗菌药物应用种类、应用时间,糖皮质激素应用情况,真菌感染部位、菌种,抗真菌药物使用情况,住院费用及平均住院天数进行分析.结果广谱抗菌药物长期大量应用则是造成真菌感染的重要因素,另外,合并应用糖皮质激素也是院内真菌感染的又一发病因素.继发医院内真菌感染,明显延长了住院时间,增加了住院费用.结论合理使用广谱抗菌药物和糖皮质激素,减少院内真菌感染,对遏制医疗费用增长,节约国家卫生资源,具有重要意义.

Objective To analyze the treatment and pharmacoeconomics in patients with chronic bronchitis complicated by deep mycotic infection in the hospital. Methods Case histories 126 patients with chronic bronchitis admitted to our hospitals from September 2003 to April 2004 were reviewed and an analysis of the kinds and duration of the application of antibiotics, the use of glucocorticoids, site of mycotic infection, kinds of fungi, the use of antimycotics , as well as expenses and average duration of hospitaligation was carried out. Results Prolonged use of large amount of broad spectrum antibiotics was the major factor leading to mycotic infection. In addition, application of glucocorticoids was another pathogenic factor inducing mycotic infection in the hospital. Chronic bronchitis complicated by mycotic infection resulted in an striking increase in the duration and expenses of hospitaligation. Conclusion Rational use of broad spectrum antibiotics and glucocorticoids, cutting down the incidence of mycotic infections in the hospital are of great significance for controlling the increase in medical expenses and saving health expenditures of our country.