氟康唑预防极低出生体重儿院内真菌感染的效果

Efficacy of Fluconazole in Prevention of Nosocomial Fungal Infection in Infants with Very Low Birth Weight

目的探讨氟康唑在极低出生体重儿院内真菌感染预防中的效果。方法将104例极低出生体重儿按随机数字表法分为对照组与观察组,每组52例。对照组予以常规抗感染及监护等对症支持治疗;观察组在对照组治疗基础上,于患儿出生后7 d给予口服氟康唑预防性治疗。比较2组患儿治疗后院内真菌感染发生率、肝功能情况、血清1,3-β-D葡聚糖含量及并发症发生情况。结果观察组院内真菌感染发生率显著低于对照组,差异有统计学意义(23.0%比36.5%,χ^2=8.004,P<0.05);2组治疗后2、4、6周肝功能指标与对照组比较,差异均无统计学意义(P>0.05);观察组血清1,3-β-D葡聚糖含量、并发症发生率均显著低于对照组(P<0.05)。结论氟康唑在极低出生体重儿院内真菌感染的预防中效果显著,脑损伤等并发症发生率较低,对肝功能影响较小,安全性高。

Objective To investigate the efficacy of fluconazole in the prevention of nosocomial fungal infection in very low birth weight infants.Methods A total of 104 very low birth weight infants were randomly divided into control group and observation group,with 52 patients in each group.Both groups received routine anti-infection,monitoring and other symptomatic support treatments.Additionally,the observation group was given prophylactic treatment with oral fluconazole 7 days after birth.The incidence of nosocomial fungal infection,liver function,serum 1,3-β-D-glucan content and complications were compared between the two groups.Results The incidence of nosocomial fungal infection in observation group was lower than that in control group(23.0%vs 36.5%,χ^2=8.004,P<0.05).There was no significant difference in liver function between the two groups 2,4 and 6 weeks after treatment(P>0.05).Serum content 1,3-β-D-glucan and incidence of complications in observation group were lower than those in control group(P<0.05).Conclusion Fluconazole is effective and safe for preventing nosocomial fungal infection and is associated with low incidence of complications(such as brain injury)and small impact on liver function in infants with very low birth weight.