探究ICU老年患者肺部真菌感染的危险因素及抢先治疗临床效果

Risk factors exploration of pulmonary fungal infection in elderly patients in ICU and the clinical effect of preemptive therapy

目的:探讨ICU老年患者肺部真菌感染的危险因素以及抢先治疗的临床效果。方法:收治老年肺部真菌感染患者130例,随机分为两组。对照组给予常规治疗,观察组给予抢先治疗,比较两组预后及危险因素。结果:观察组的APACHEⅡ评分、MODS的发生率低于对照组,住院时间短于对照组,差异具有统计学意义(P<0.05)。两组病死率比较,差异无统计学意义(P>0.05)。长期服用抗生素、侵入性操作机械通气时间≥1周、ICU住院时间≥2周、免疫功能低下、激素应用>4 d、并发糖尿病是诱发疾病的主要危险因素。结论:ICU老年患者肺部真菌感染的危险因素较多,抢先治疗可有效促进患者恢复,缩短住院时间。

Objective:To investigate the risk factors of pulmonary fungal infection in elderly patients in ICU and the clinical effect of preemptive therapy.Methods:130 cases of elderly patients with pulmonary fungal infection were divided into two groups randomly.The control group was given conventional treatment.The observation group was given preemptive treatment.The prognosis and risk factors of the two groups were compared.Results:The APACHE Ⅱ scores,incidence of MODS in the observation group were lower than those in the control group;the hospitalization time was shorter than that of the control group;thedifferences were statistically significant (P<0.05).There was no statistically significant difference of mortality between groups (P>0.05).Long-term use of antibiotics, invasive mechanical ventilation operation time 1 week, ICU or hospital stay 2 or moreweeks, immunocompromised, hormone application > 4 days, complicated with diabetes were major risk factors for illness.Conclusion:There were many risk factors of pulmonary fungal infection in elderly patients in ICU,and preemptive therapy could promote the recovery of patients effectively and shorten the hospitalization time.