新生儿侵袭性真菌感染的临床特点分析

Clinical characteristics of invasive fungal infection in neonates

目的分析新生儿侵袭性真菌感染的临床特点，以提高该病的诊治水平，降低漏诊率。方法收集我院2012年1月至2015年3月新生儿病房收治的66例确诊侵袭性真菌感染患儿的临床资料，对患儿的一般情况、发病时间、首发症状、实验室检查、血培养结果、治疗转归、随访情况进行回顾性分析。结果侵袭性真菌感染的平均发病日龄为（18．6±9．1）d；临床表现不典型，以呼吸暂停、喂养不耐受、发热、精神反应差、活动少为首发症状；实验室检查表现为血小板减少及C-反应蛋白增高、（1，3）-β-D葡聚糖增高；血培养以念珠菌为主；氟康唑治疗效果好。结论新生儿真菌感染临床表现缺乏特异性，对有高危因素的患儿需高度警惕真菌感染的可能，早期诊断、及时治疗是治疗成功的关键。

Objective To analyze the clinical features of invasive fungal infection in neonates,in or- der to raise the level of diagnosis and treatment of this disease. Methods We collected the clinical data of 66 cases who were admitted to our neonatal ward between January 2012 and March 2012, and confh-med invasive fungal infection. The data which included general situation, onset time, the first symptoms, laboratory exami- nation results, blood culture results, treatment and outcomes, prognosis and follow-up status were analyzed ret- rospectively. Results The average onset age of invasive fungal infection was （ 18.6 _＋ 9. 1 ） day-old. The clinical manifestations of the children patients were atypical, with the first clinical presentation of apnea, feed- ing intolerance, fever, poor response and less activity. The laboratory examination results were thrombocytope- nia,elevated C-reactive protein and（ 1,3 ） -13-D-glucan. The blood culture results mainly were Candida. And fluconazole treated was effective. Conclusion Fungal infection in neonate is lack of specific clinical mani- festations. We should be on high alert for the neonate who has high risk factors of fungal infections. Early diagnosis and prompt treatment is the key to successful treatment.