CAJ | 학술논문

目的分析ICU老年患者发生真菌菌血症的临床特点和病原体特性,为真菌菌血症的防治提供依据.方法回顾性分析2005年10月-2008年10月我院ICU 6例真菌菌血症患者的临床特点.结果低蛋白血症6例,广谱抗生素应用6例,机械通气6例,中心静脉置管6例,留置导尿管6例,急性生理慢性健康评分(APACHEⅡ)≥20分4例,气管插管4例,气管切开2例,激素应用2例,床旁连续性血液滤过治疗2例,肿瘤2例,慢性肾衰竭1例,全胃肠外营养1例;分离出白色假丝酵母菌2例,热带假丝酵母菌2例,光滑假丝酵母菌1例,近平滑假丝酵母菌1例;氟康唑耐药1例.结论 ICU真菌血症病死率高与广谱抗生素应用、中心静脉置管、低蛋白血症、高APACHEⅡ评分及激素应用等危险因素相关.
목적 분석ICU노년환자발생진균균혈증적림상특점화병원체특성,위진균균혈증적방치제공의거.방법 회고성분석2005년10월-2008년10월아원ICU 6례진균균혈증환자적림상특점.결과 저단백혈증6례,엄보항생소응용6례,궤계통기6례,중심정맥치관6례,류치도뇨관6례,급성생리만성건강평분(APACHEⅡ)≥20분4례,기관삽관4례,기관절개2례,격소응용2례,상방련속성혈액려과치료2례,종류2례,만성신쇠갈1례,전위장외영양1례;분리출백색가사효모균2례,열대가사효모균2례,광활가사효모균1례,근평활가사효모균1례;불강서내약1례.결론 ICU진균혈증병사솔고여엄보항생소응용、중심정맥치관、저단백혈증、고APACHEⅡ평분급격소응용등위험인소상관.
Objective To analyze the clinical features and pathogen characteristics of fungemia in elderly patients in ICU to provide a basis for its prevention and treatment.Methods A retrospective analysis was conducted on clinical features of 6 fungemia patients admitted to our ICU from October 2005 to October 2008.Results Six patients had hypoproteinemia,6 used broad-spectrum antibiotics,6 were given mechanical ventilation,6 given central venous catheters,6 given indwelling catheters,4 had ≥20 scores of acute physiology and chronic health evaluation (APACHE II),4 given tracheal tube,2 received tracheotomy,2 used hormone,2 had bedside continuous hemofiltration treatment,2 had tumors,1 had chronic renal failure,1 received total parenteral nutrition;Candida albicans bacteria were isolated in 2 patients,Candida tropicalis yeast in 2,smooth Candida yeast in 1;fluconazole resistance was noted in 1.Conclusion The high fatality rate of ICU Fungemia is related to broad-spectrum antibiotic use,central venous catheters,hypoalbuminemia,high APACHE II scores,and hormone use.