大面积烧伤合并真菌感染分析

Analysis of fungal infection in extensive burn

目的：探讨大面积烧伤病人感染真菌感染的原因，临床表现，治疗及预防措施。方法：回顾自2013年5月-2017年9月我们救治的120位大面积烧伤患者（烧伤面积达50％-90％）中有20位患者创面出现了真菌。多出现在创面，静脉导管。其主要诱因是长时间应用广谱抗生素导致机体内菌群失调和大面积烧伤皮肤脱失，保护屏障遭到破坏。同时创面较大且愈合时间长，导致机体消耗大，抵抗力低下，营养状况比较差和创面包扎治疗提供了温暖湿润的环境，以及长期置留静脉导管也是导致真菌感染的易感因素。结果：大面积烧伤病人在一定环境下容易感染真菌。多为白色念珠菌，偶发黄曲霉菌及其他真菌。结论：合理控制抗生素使用，早期服用抗菌药物及清创，暴露创面增加换药次数，勤翻身保持创面干燥及定期通风可有效预防创面真菌感染。

Objective： To investigate the causes of fungal infection in large area burn patients, clinical manifestations, treatment and preventive measures. Methods： to review the presence of 20 patients （50 % to 90% of burn area） from May 2013 to September 2017. It appeared in the wound, the venous catheter. The main inducement was prolonged application of broad - spectrum antibiotics, which resuits in the dissonance of the organism and widespread bum skin, and the protection of the barrier was destroyed. Large wound and the healing time was long, at the same time cause the body was used up big, low resistance, poor nutritional status and wound dressing for treatment provides a warm and humid environment and long - term withhold venous catheter and lead to the risk factors of fungal infection. Results： patients with large.area bums were susceptible to fungi in certain environment. It was white candida albicans, aspergillus asper- gillus and other fungi. Conclusion： reasonable control antibiotics, antibacterial drugs and early debridement, increased exposure wound dressing, often turn to keep the wound dry and ventilated regularly to be effective in preventing fungal infection of the wound.