小儿血液病并发深部真菌病

Deep mycoses in childhlood hematologic diseases

探讨小儿血液病并发深部真菌病的发病原因、临床特点、防治措施与预后。方法根据病原学、影像学检查并结合临床资料综合分析。结果11例急性白血病（其中1例为慢性粒细胞白血病急淋变）及1例再生障碍性贫血于白细胞低下期出现肺部真菌感染或多脏器真菌感染，其中7例经抗真菌治疗后恢复，2例死亡，3例放弃治疗。结论深部真菌病是继发于白细胞低下及大量广谱抗生素应用的重要合并症，多次痰涂片是简便、快速有效的早期诊断手段之一，在治疗原发病的同时早期诊断治疗深部真菌病是改善预后的关键。

To investigate the pathogenic factors. clinical features. preventive measures and prognosis. of deep mycoses in leukemia and aplastic anemia patients.Methods: The general analysis was done according to the etiology. combined with clinical manifestations .examinations of sputum smears .sputum and blood cultures and imaging studies.Results: Deep mycoses were diagnosed in 11 cases of acute leukemia (1 case of chronic myelogenous leukemia progression to lymphoid blast crisis )and 1 case of aplastic anemia. They all occurred during neutropenic periods. 7 out of 12 cases were recovered. 2 cases died and 3 cases rejected treatment.Conclusion: Deep mycoses were severe complications in hematologic patients who became neutropenic and treated by broad spectrum antibiotics. Examinations of repeat sputum smears were simple. rapid and effective early diagnostic methods. Early diagnosis and treatment of deep mycoses combined with treatment of primary disease may be the key to the impovement of prognosis.