血浆置换术后医院深部真菌感染临床分析

Deep Fungal Infection after Plasmapheresis : A Clinical Analysis

目的探讨人工肝血浆置换术后重型肝炎患者并发深部真菌感染的危险因素及防治。方法回顾分析我院69例人工肝血浆置换术后深部真菌感染的临床资料。结果真菌感染占同期血浆置换术后医院感染病例的60.52%,感染部位以口腔、肠道为主,其次为肺部;感染真菌类型主要为白色念珠菌、热带念珠菌、曲霉菌、毛霉菌等;感染发生与患者原发病、人工肝术后机体抵抗力降低、抗生素应用等有关;肺部真菌感染占28.98%,病死率为70.0%,其中肺曲霉病4例、毛霉病6例,无一例存活。结论血浆置换术后真菌感染发病率较高,肺部真菌感染是更危险的因素,预后极差;重视预防措施、早期诊断治疗是减少真菌感染、降低病死率的关健。

OBJECTIVE To investigate risk factors of deep fungal infection after plasmapheresis in severe viral hepatitis B patients, and their preventive and therapeutic measures. METHODS A total of 69 cases inpatients with severe viral hepatitis B were retrospectively analyzed. RESULTS Deep fungal infection which was detected in 60.52% of hospital infection cases in the same time,took place more frequently in oral cavity, and in lung and intestinal tract. The main fungi were Candida albicans,C. tropicalis,Mucor, Aspergillus, etc, CONCLUSIONS Early diagnosis and treatment are important to reduce deep fungal infection after plasmapheresis.