老年慢性病继发肺部真菌感染预防进展

Prevention of chronic secondary pulmonary fungal infection among the aged

老年慢性病继发肺部真菌感染逐年增多,继发肺部真菌感染诊断困难,治疗难度大,严重威胁老年慢性病者的生命,因此,老年慢性病者预防继发肺部真菌感染具有重要的临床意义.部分学者对老年人使用抗生素后继发肺部真菌感染及老年慢性病继发肺部真菌感染的特点及原因进行了分析,报道了老年患者发生真菌感染的易感特点、影响因素,并提出一些预防措施,在预防继发肺部真菌感染方面做出了较大的贡献,目前针对老年慢性病继发肺部真菌感染的特点进行系统研究预防对策较少,本研究的预防对策内容如下：①给老年慢病者肌注肺炎疫苗每3年0.5 mL、流感疫苗每年0.5 mL,增强机体免疫力.②控制慢病症状,减少住院次数,根据血培养、药敏试验选用窄谱抗菌药,宜小剂量配双黄连等中药使用,用药7～10 d停药.③加强口腔、咽部护理,使用0.3％碳酸氢钠盐水含漱.采用本预防对策能有效预防老年慢性病继发肺部真菌感染的发生,能减少住院次数,缩短老年慢性病患者的住院时间,降低老年慢性病对药物的耐药性,提高治愈率,减轻患者的经济负担,降低老年慢性病患者的病死率,值得临床进一步研究.

The cases of chronic secondary pulmonary fungal infections have increased every year among the aged.It is difficult to diagnose and treat those cases so they are seriously threatening the lives of those aged.Therefore,the study of those cases holds important clinical significance to the prevention of this disease.Recently,some researchers have made some analysis on the causes and characteristics of the chronic secondary pulmonary fungal infection and this infection after the antibiotics usage.They reported the susceptive characteristics,factors and then offered some preventive measures.Though those researches made contribution to the prevention of this disease,they can＇t provide us with systematic prevention measures.So this article intends to study the measures against the chronic secondary pulmonary fungal infections.The measures consist of three aspects：one,to increase the aged＇s immunity,we suggest intramuscular injection of 0.5 mL pneumonia vaccine every three years and 0.5 mL flu vaccine to them; two,to control the aged＇s chronic disease symptoms and reduce their hospitalizations,we suggest choosing narrow-spectrum antibiotics combine with small dose of medicine of Shuang Huang Lian （medication 7 to 10 days） according to their blood culture and susceptibility testing; three,strengthen the mouth,pharynx care,use 0.3％ sodium bicarbonate salt water to gargle.Our research shows that by adopting the preventive measures,the patients can effectively prevent chronic secondary pulmonary fungal infection,reduce their hospitalizations,reduce their drug resistance,improve the cure rate and reduce the mortality of the elderly patient.So it is very necessary to further the research.