重症监护室的院内肺部真菌感染临床研究

Nosocomial Pulmonary Fungal Infection in ICU: A Clinical Study

目的 研究重症监护室（ICU）的院内肺部真菌感染的易感因素和防治措施。方法 回顾分析我科1996年8月～2001年8月,73例院内肺部感染患者的临床资料。结果 院内真菌肺部感染的发生率在ICU为10.34％,念珠菌占88％,主要表现有大量白色淡黄稀痰,诱发因素主要有病情危重、气道开放、不合理使用广谱抗生素、长期使用激素等,氟康唑疗效好。结论 应重视消除诱发因素、早期诊断和治疗。

OBJECTIVE To study the susceptible factors,the methods of prevention and treatment of nosocomial pulmonary fungal infection in ICU. METHODS The clinical materials of 73 patients with nosocomial pulmonary fungal infection in our department from August 1996 to August 2001 were reviewed. RESULTS The infection rate of it in total 709 patients was 10. 34%. Candidiasis was the most frequent type in fungal infection, 88% of which were due to Candida, the most clinical features were a large amount of light yellow sputum after tracheotomy and intratracheal indwelling cannula. The factors related to nosocomial pulmonary fungal infection were the severity of the primary disease, tracheal intubations, broadspectrum antibiotics abuse, long-term use of gluco-corticoid, etc. Fluconazole has better clinical effects on treatment of fungal infection than other antifungal drugs. CONCLUSIONS It's important to eliminate the susceptible factors and to provide the early diagnosis and trea-ment.