62例骨髓移植患者应用抗真菌药物预防的临床疗效分析

Analysis of clinical effect of antifungal agents in 62 cases of bone marrow transplant patients

目的分析骨髓移植过程中应用抗真菌药物预防和治疗的临床疗效。方法回顾性分析近5年来我科进行的62例骨髓移植治疗的患者真菌感染的情况，以及抗真菌药物预防和治疗的应用情况。其中A组：移植前无真菌感染38例；B组：移植前有临床拟诊断真菌感染24例且在移植前病灶稳定。每例患者在移植过程中均接受各种抗真菌药物干预。结果62例患者总真菌感染率为12．9％，其中A组患者使用口服抗真菌药物预防总真菌感染率为5．26％，B组使用口服药物预防感染率为60％，使用广谱抗真菌针剂药物预防感染率是0％，口服药物加针剂预防总感染率为25％。结论骨髓移植患者真菌感染发生率高，要根据患者既往真菌感染的情况选择不同抗菌谱和抗菌强度的药物。

Objective To analyze the clinical efficacy of antifungal drug treatment in patients after bone marrow transplantation. Methods Analysis retrospectively the fungal infection rate and the application of antifungal agents in 62 cases of bone marrow transplant patients in the past 5 years in our center. Group A （38 cases） was no fungal infections before bone marrow transplantation. Group B （24 case） was of clinical diagnosis of fungal infection which is stable pre-transplant. All 62 patients accepted a variety of antifungal agents treatment in the transplant process. Results Fungal infection rate in total 62 cases was 12.9%. Of them the rate of prevent fungal infection by antifungal agents orally in group was 5.26% and 60% in group by oral drugs. The rate of broad-spectrum antifungal drug injections to prevent infection was 0%, and the rate of oral plus injection to prevent the total infection was 25%. Concltsion The incidence of fungi was high in bone marrow transplantation. The choice of different antimicrobial spectrum and intensity of antimicrobial drugs were based on patients with previous fungal infections.