摘要
目的:了解近年来呼吸科重症监护病房(RICU)院内肺部真菌感染的发病情况、相关因素、菌株分析及治疗现状。方法:对2003年1月~2008年12月我院RICU诊断的51例院内肺部真菌感染患者的临床资料进行回顾性分析。结果:近六年RICU共诊断51例院内肺部真菌感染患者,均为临床诊断,其发病率显著高于同时期普通病房的发病率(11.78%比1.75%,P<0.01)。COPD和细菌性肺炎是最常见的呼吸系统基础疾病分别占33.3%和35.3%;43例(84.3%)患者具有肺部真菌感染的高危因素。与普通病房相比,RICU患者的曲霉菌感染所占比例更高(9.8%),但二者无显著差异(P>0.05)。抗真菌治疗有效率为82.4%,氟康唑为最常见的抗真菌药物。与普通病房相比,RICU患者的死亡率升高为17.6%,但二者无显著差异(P>0.05)。结论:RICU患者院内肺部真菌感染的发病率明显高于普通病房,因预后相对较差,应早期采用有效的干预措施。
Objective :To analyze the morbility, risk factors, etiology, treatment and outcome of nosocomial pulmonary fungal infections in respiratory intensive care unit (RICU). Methods: 51 patients with nosocomial pulmonary fungal infections in RICU between Jan 2003 and Dee 2008 were retrospectively analyzed. Results:All of 51 cases were clinically diagnosed as probable nosocomial pulmonary fungal infections ,with the morbidity of 11.78% signifieandy higher than general wards ( 1.75%, P 〈 0.01 ). COPD and bacterial pneumonia were the major underlying diseases of respiratory system with a percent of 33.3% and 35.3% respectively,43 patients (84.3%) had risk factors for fungal infections. Compared with general wards, the proportion of aspergillosis was higher in RICU without significant difference ( P 〉 0.05 ). The effective rate of antifungal treatment was 82.4% and flueonazol was the most common used antifungal agents. The mortality of fungal infection in RICU was higher than that of general wards but without significant difference ( P 〉 0.05 ). Conclusions:The morbidity of nosocomial pulmonary fungal infection in RICU is higher than in general wards. Early and effective treatment is needed in these patients considering the poor prognosis.
出处
《甘肃医药》
2009年第5期330-332,共3页
Gansu Medical Journal
关键词
肺炎
真菌感染
医院感染
重症监护病房
Pneumonia
Fungal infections
Nosocomial infections
Intensive care unit