白血病患儿合并中枢神经系统深部真菌感染临床分析

Clinical analysis of deep fungal infection of central nervous system in children with leukemia

目的分析白血病患儿合并中枢神经系统深部真菌感染的临床特点,探讨诊断和干预方法。方法回顾性分析我院儿科病房2013-01—2016-02收治的32例并发中枢神经系统深部真菌感染的白血病患儿的临床资料,分析临床特点,总结诊断和干预方法,以期为白血病患儿并发中枢神经系统深部真菌感染提供有效的预防和干预措施。结果本组32例患儿中男性、年龄>3~7岁、假丝酵母菌属和曲霉菌属构成比较高,分别为75.00%、50.00%、40.62%和25.00%;经治疗和照护后死亡2例,病死率6.25%;治疗过程中不良反应发生率为12.50%。结论白血病患儿合并中枢神经系统深部真菌感染多发生于男性、年龄>3~7岁者中,多由假丝酵母菌属和曲霉菌属感染引发,预后较差,可给予两性霉素B和伏立康唑联合治疗,辅以综合照护。

Objective To analyze the clinical characteristics of deep fungal infection of central nervous system in children with leukemia,and to explore the methods of diagnosis and intervention. Methods Retrospective analysis of 32 leukemia patients with deep fungal infection in central nervous system in pediatric ward of our hospital from January 2013 to February 2016,, annlyze clinical characteristics,summarize the methods of diagnosis and intervention,in order to provide effective prevention and interventions for leukemia patients with deep fungal infections in the central nervous system. Results In the 32 cases,the composi- tion of male,age more than from3 to 7 years old, Candida and Aspergillus was relatively high, The ratio was 75.00 %,50.00%, 40.62 % and 25.00 %, respectively. 2 cases died after treatment, the fatality rate was 6.25 % ;the incidence rate of adverse reaction was 12.50% during the treatment. Conclusion Leukemia patients with deep fungal infections in the central nervous system were more occurred in male, the age more thanfrom 3 to 7 years old, from Candida and Aspergillus infection, the prognosis is poor, which can be given to amphotericin B and voriconazole treatment,combined with comprehensive care.