氟康唑预防早产儿深静脉置管时真菌感染临床分析

Clinical analysis of fluconazole prophylaxis against invasive fungal infection in preterm neonates with peripherally inserted central catheters

目的:探讨口服小剂量氟康唑预防早产儿经外周穿刺中心静脉置管(PICC)时侵袭性真菌感染的疗效性和安全性。方法:对照分析放置PICC的早产儿。其中口服氟康唑预防真菌感染为预防组,未口服氟康唑为对照组。比较分析真菌感染的发生率及药物的安全性。结果:对照组与预防组患儿的基本临床特点及侵袭性真菌感染的危险因素类似。72例预防组患儿中无导管相关性真菌血症发生,侵袭性真菌感染发生率1.39%,而54例中导管相关性真菌血症的发生率为7.41%,侵袭性真菌感染发生率14.81%,两组比较有统计学意义(P<0.05)。在预防用药后2周、4周比较两组肝功能指标,无差异。结论:小剂量氟康唑可有效预防早产儿PICC置管相关真菌感染,临床安全性较好。

Objective： Explore the efficacy and safety of oral low-dosage of fluconazole against invasive fungal infection in premature infants who had peripherally inserted central catheter. Methods： The premature infants with PICC were selected and devided into two groups,which were control group without fluconazole and prophylaxis group with oral fluconazole against fungal infection.The safety and incidence of invasive fungal infection were compared and analyzed. Results： There were no significantly differences in the baseline clinical characteristics and risk factors for invasive fungal infection between the two groups.In control group,the incidence of fungemia related to catheter and invasive fungal infection was 7.41% and 14.81%.In prophylaxis group,no case of fungemia related to catheter was found,and the incidence of invasive fungal infection was only 1.39%.There was signifecant difference（P〈0.05）.Compared to infants in control group,the hepatic biochemical indicator showed no significant changes in prophylaxis group at 2 and 4 weeks after fluconazole prophylaxis. Conclusion： For preterm infants with PICC insertions,the strategy of oral low-dosage fluconazole against fungal infection is effectively and safe.