肝衰竭患者合并肺曲霉菌病7例临床分析

Clinical description for 7 cases of hepatic failure patients complicated with pulmonary aspergillosis

目的:探讨肝衰竭患者合并肺曲霉菌病的临床特点。方法:收集东南大学医学院附属第二医院近4年被诊断为肝衰竭合并肺曲霉菌病7例患者的临床资料并进行相关分析。结果:7例患者均有使用广谱抗生素、人工肝治疗;5例激素治疗。临床表现为发热、咳嗽、咳痰、胸闷,血象明显增高,肺部浸润性病变。6例进行抗真菌治疗,1例死亡。行抗真菌治疗的6例病情恶化,放弃治疗,自动出院后随访均死亡。结论:肝衰竭患者合并肺曲霉菌病,大多有使用广谱抗生素、激素和人工肝治疗,处于肝衰竭终末期,病死率高,早期诊断、及时治疗可能改善预后。

Objective： To explore the clinical features of pulmonary aspergillosis in the patients with hepatic failure. Methods： We retrospectively analyzed the clinical features,therapy and prognosis of pulmonary aspergillosis infection in all seven patients with hepatic failure in our hospital from January 2009 to January 2012. Results： The artificial liver support system and broad-spectrum antibiotics were performed in all 7 patients,corticosteroids were treated in 5 of 7 cases,and antifungal agents were administrated in 6 of 7 subjects. All the patients died. Conclusion： The hepatic failure patients complicated with aspergillosis infection result in disease progression,poor prognosis and increased mortality. Therefore,early diagnosis,elimination of predisposing factors and correct treatments for aspergillosis would improve survival.