病理确诊深部真菌病45例分析

Deep fungal infection determined by pathological inspection

目的 探讨深部真菌病病理诊断的价值。方法 回顾性分析我院1995年1月-2004年12月期间，经病理确诊为深部真菌病45例患者的临床及病理资料，其中副鼻窦真菌感染14例；肺部真菌病19例；胃肠道真菌病4例；口腔真菌病2例，脑部真菌病2例，其他真菌病4例。结果 我院近5年来真菌病的确诊病例明显增多，且内脏及器官真菌病患者多合并基础性疾病，如血液病、肿瘤等。部分病例的致病菌根据病理确定有曲霉、念珠菌及隐球菌等。临床上主要采用手术结合氟康唑静滴的治疗方法。结论 我院经病理确诊的真菌病例呈上升趋势，病理组织学特点结合特殊染色可将大部分致病菌鉴定至属，治疗前最好进行培养鉴定至种。

Objective To investigate the pathological and clinical characteristics of deep fungal infections. Methods Total 45 cases of deep mycoses diagnosed by pathological findings from 1995.1 to 2004.12 were enrolled for our study, including 14 cases involving accessory nasal cavity; 19 cases involving lung; 4 cases involving gastrointestinal tract;2 cases involving oral cavity;2 cases involving central nervous system and 4 cases involving other parts. We further analysed the clinical and pathological features of these cases. Results More cases of deep mycoses was found in recent 5 years than in the former 5 years. Almost all cases involving internal organs had underling diseases such as hematologic diseases and malignant tumors. Most cases were diagnosed as aspergillosis, candidiasis and cryptococcosis, which based on their histopathological features combined with specific stain. These cases had been treated with surgical intervention and Fluconazol. Conclusion The incidental rate of deep fungal infection in our hospital had increased obviously. The histopathological features combined with specific stain can help to determine the pathogen.