CAJ | 학술논문

目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)并发深部真菌感染(deep fungal infection,DFI)的特点及防治. 方法回顾性分析1998年10月至2009年10月我科收治的135例SAP患者的临床资料,其中并发DFI的32例,男19例,女13例,平均年龄(56±5)岁.结果本组死亡7例(占21.9%),32例平均住重症监护室时间(21±6)d、住院时间(78±14)d、治疗费用(13.5±0.7)万元.SAP合并DFI患者具有以下特点:病情重、病程长、需住重症监护室治疗、多需手术清除感染灶、需长期留置各种导管、接受气管插管机械通气、肠外营养及长期使用广谱抗菌素治疗等特点.结论 SAP合并DFI具有较高发生率及病死率.应采取防治结合的措施,如:恰当处理原发病,严格无菌操作,合理应用抗生素和预防性应用抗真菌药等,可降低SAP合并DFI的发生率、病死率.
목적 탐토중증급성이선염(severe acute pancreatitis,SAP)병발심부진균감염(deep fungal infection,DFI)적특점급방치. 방법회고성분석1998년10월지2009년10월아과수치적135례SAP환자적림상자료,기중병발DFI적32례,남19례,녀13례,평균년령(56±5)세.결과 본조사망7례(점21.9%),32례평균주중증감호실시간(21±6)d、주원시간(78±14)d、치료비용(13.5±0.7)만원.SAP합병DFI환자구유이하특점:병정중、병정장、수주중증감호실치료、다수수술청제감염조、수장기류치각충도관、접수기관삽관궤계통기、장외영양급장기사용엄보항균소치료등특점.결론 SAP합병DFI구유교고발생솔급병사솔.응채취방치결합적조시,여:흡당처리원발병,엄격무균조작,합리응용항생소화예방성응용항진균약등,가강저SAP합병DFI적발생솔、병사솔.
Objective To investigate the characteristics and prevention of deep fungal infection (DFI) complicated by severe acute pancreatitis (SAP). Methods Clinical data of 135 SAP cases admitted from Oct. 1998 to Oct. 2009 were studied, the prevention and management of SAP with DFI ( 32cases) were investigated, among them there were 19 males and 13 females. Results Seven patients (21.9%) died of these 32 cases. The SAP patients with DFI were of more critical condition, longer course and having to stay in ICU about (21±6) d, most needed surgical debridement, on long-term indwelling catheters, intubation and mechanical ventilation, parenteral nutrition, long-term use of broad-spectrum antibiotics. These patients remained in the hospital for about (78 ± 14) d. Conclusions DFI is a common complication in SAP cases causing a significant mortality hence necessitating comprehensive prevention and control measures such as proper handling of the original disease, aseptic operation, prophylactic antibiotics and antifungal agents, which can reduce the incidence and mortality of SAP with DFI.