34例老年慢性支气管炎合并肺部真菌感染临床特征分析

Clinical Features of 34 Elderly Patients with Chronic Bronchitis Complicated by Pulmonary Fungal Infection

目的探讨老年肺部真菌感染的危险因素、特点、诊断以及治疗。方法对我院34例老年慢性支气管炎合并肺部真菌感染患者进行回顾性分析,选择同期单纯老年慢性支气管炎患者作为对照组,比较两组合并肺部真菌感染危险因素。结果合并真菌感染组中低蛋白血症、侵入性操作、使用两种以上广谱抗生素和长期应用糖皮质激素比例显著高于对照组(P<0.05)。最常见的感染菌株为白色念珠菌,经过治疗后,本组痊愈12例,好转11例,6例无变化,死亡5例。治疗有效率(痊愈+好转)67.6%。结论院内真菌感染是呼吸道疾病的重要继发病症,分析老年人肺部继发性真菌感染的相关特征,对预防治疗有重要意义。

Objective To investigate the risk factors,clinical characteristics, diagnosis and treatment of pulmonary fungal infection in elderly patients. Methods Thirty-four cases of chronic bronchitis complicated by pulmonary fungal infection were retrospectively analyzed. The elderly patients with chronic bronchitis were selected in same period as the control group,and were compared with pulmonary fungal infection risk factors. Results Fungal infection in hypoproteinemia, invasive procedures,using two or more broad-spectrum antibiotics and corticosteroids were significantly higher （P〈O.05）. The candida albicans was the common pathogen,12 cases were recovered in this group,improved in 11 cases, 6 cases of no change, 5 cases died. Treatment response rate was 67.6%. Conclusion Nosocomial fungal infection is an important secondary disease,and analysis of the elderly secondary pulmonary fungal infection-related characteristics to the prevention and treatment are important.