氟康唑针预防儿科重症监护病房真菌感染的疗效及安全性

Preventive Effect and Safety of Fluconazol on Fungal Infection in Pediatric Intensive Care Unit

目的探讨氟康唑小剂量低频率预防医院真菌感染的效果。方法儿科重症监护病房(PICU)重症感染和基础疾病并重症感染患儿应用广谱或超广谱抗生素及类固醇激素200例患儿,分为对照组与治疗组。治疗组应用小剂量低频率氟康唑预防真菌感染,5mg/(kg.次),隔日1次,共3次,继后每周2次(间隔2～3d)至病情好转。对照组发生真菌感染后予氟康唑6～10mg/(kg.次),1次/d,疗程10～14d。比较二组患儿真菌感染情况。结果对照组真菌感染发生率为58.3%(56/96例),分别为口腔44例,呼吸道、消化道各5例,泌尿道2例;痊愈37例,好转17例,无效2例。治疗组真菌感染发病率为1.9%(2/104例),仅口腔2例。治疗组口腔真菌感染程度轻,局部用药1、2次后治愈,未出现肝功能损害或肝损害加重。结论对PICU的高危患儿预防性小剂量低频率应用氟康唑,是预防医院真菌感染的一种有效、相对安全的可靠措施。

Objective To study the preventive effect of small - dose fluconazol adiministered in low frequency on nosocomial fungal infectoin. Methods The condition of nosocomial fungal infection among 200 patients in pediatric intensive care unit （ PICU ） were observed, who were suffered with serious infection or basic diseases and underwent broad - spectrum or ultra - broad spectrum antibiotic and steroid hormones treatment. These patients were divided imto treatment and control group. And the patients in treatment group received fluconazol [ 5 nag/（ kg · time ） once every 2 days, total 3 times, after that, twice 1 week till improved ] to prevent fungal infection . The control group were treated with fluconazol [6 - 10 mg/（ kg · time） ,once everyday for 10 - 14 days] after fungal infection. Results The incidence rate of nosocomial fungal infectoin of control group was 58.3 % （56 out of 96 cases, which were 44 cases of mouth,5 cases of respiratory tract ,5 cases of digestive tract and 2 cases of urethra ） and that of treatment group was 1.9% （2 out of 104 cases, which were 2 cases of mouth）. In control group,37 cases were cured ,17 cases improved and 2 cases were not effective. Mouth fungal infection in treatment group was gently and cured with 1 or 2 times of local treatment . The treatment group didn＇t occured liver function damage or aggravation. Conclusion For PICU patients, adiministration of small-dose flueomasol in low frequency is an effective and relatively safety method to prevent against nosocomial fungal infectoin.