中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2014年
17期
37-39,64
,共4页
肺部%真菌感染%菌种分类%易患因素%临床分析
肺部%真菌感染%菌種分類%易患因素%臨床分析
폐부%진균감염%균충분류%역환인소%림상분석
Lungs%Fungal infection%Bacterial classification%Susceptible factors%Clinical analysis
目的：探讨肺部真菌感染的常见菌种、易患因素及临床特点，以加强临床认知。方法回顾性分析2012年11月~2013年11月邯郸市传染病医院77例肺部真菌感染患者的临床资料，对其病史、真菌菌种分类、易患因素、诊治及预后情况进行总结和分析。结果肺部真菌感染的易患因素有慢性肺部疾病及滥用药物等，其中合并慢性阻塞性肺疾病32例(41.56%)，肺结核17例(22.08%)，2型糖尿病11例(14.29%)，低蛋白血症7例(9.09%)，开胸术后2例(2.60%)，肺癌并发肺部真菌感染3例(3.90%)，肝炎后肝硬化并发肺部真菌感染3例(3.90%)，血液病并发肺病真菌感染2例(2.60%)，长时间应用广谱抗生素49例(63.64%)，应用糖皮质激素15例(19.48%)。检出的真菌种类以酵母菌属为主，白色念珠菌47例(61.04%)，光滑念珠菌23例(29.87%)，热带念珠菌3例(3.90%)，曲霉菌4例(5.19%)。确诊后主要应用氟康唑、伏立康唑、5-氟胞嘧啶、两性霉素B等抗真菌治疗，其中55例(71.43%)治愈，20例(25.97%)好转，总体治疗效果较好。结论针对肺部真菌感染的病因、菌种尽早正确诊治是其能否治愈的关键，因此积极综合治疗，提高患者机体免疫力，剔除与肺部真菌感染有关的危险易患因素，及时应用抗真菌药物进行干预，可获得比较满意的治疗效果。
目的：探討肺部真菌感染的常見菌種、易患因素及臨床特點，以加彊臨床認知。方法迴顧性分析2012年11月~2013年11月邯鄲市傳染病醫院77例肺部真菌感染患者的臨床資料，對其病史、真菌菌種分類、易患因素、診治及預後情況進行總結和分析。結果肺部真菌感染的易患因素有慢性肺部疾病及濫用藥物等，其中閤併慢性阻塞性肺疾病32例(41.56%)，肺結覈17例(22.08%)，2型糖尿病11例(14.29%)，低蛋白血癥7例(9.09%)，開胸術後2例(2.60%)，肺癌併髮肺部真菌感染3例(3.90%)，肝炎後肝硬化併髮肺部真菌感染3例(3.90%)，血液病併髮肺病真菌感染2例(2.60%)，長時間應用廣譜抗生素49例(63.64%)，應用糖皮質激素15例(19.48%)。檢齣的真菌種類以酵母菌屬為主，白色唸珠菌47例(61.04%)，光滑唸珠菌23例(29.87%)，熱帶唸珠菌3例(3.90%)，麯黴菌4例(5.19%)。確診後主要應用氟康唑、伏立康唑、5-氟胞嘧啶、兩性黴素B等抗真菌治療，其中55例(71.43%)治愈，20例(25.97%)好轉，總體治療效果較好。結論針對肺部真菌感染的病因、菌種儘早正確診治是其能否治愈的關鍵，因此積極綜閤治療，提高患者機體免疫力，剔除與肺部真菌感染有關的危險易患因素，及時應用抗真菌藥物進行榦預，可穫得比較滿意的治療效果。
목적：탐토폐부진균감염적상견균충、역환인소급림상특점，이가강림상인지。방법회고성분석2012년11월~2013년11월함단시전염병의원77례폐부진균감염환자적림상자료，대기병사、진균균충분류、역환인소、진치급예후정황진행총결화분석。결과폐부진균감염적역환인소유만성폐부질병급람용약물등，기중합병만성조새성폐질병32례(41.56%)，폐결핵17례(22.08%)，2형당뇨병11례(14.29%)，저단백혈증7례(9.09%)，개흉술후2례(2.60%)，폐암병발폐부진균감염3례(3.90%)，간염후간경화병발폐부진균감염3례(3.90%)，혈액병병발폐병진균감염2례(2.60%)，장시간응용엄보항생소49례(63.64%)，응용당피질격소15례(19.48%)。검출적진균충류이효모균속위주，백색념주균47례(61.04%)，광활념주균23례(29.87%)，열대념주균3례(3.90%)，곡매균4례(5.19%)。학진후주요응용불강서、복립강서、5-불포밀정、량성매소B등항진균치료，기중55례(71.43%)치유，20례(25.97%)호전，총체치료효과교호。결론침대폐부진균감염적병인、균충진조정학진치시기능부치유적관건，인차적겁종합치료，제고환자궤체면역력，척제여폐부진균감염유관적위험역환인소，급시응용항진균약물진행간예，가획득비교만의적치료효과。
Objective To explore the common strains, susceptible factors and clinical characteristics of pulmonary fun-gal infection, and strengthen clinical cognition. Methods Clinical data of 77 patients with pulmonary fungal infection from November 2012 to November 2013 in the Infectious Diseases Hospital of Handan City were retrospectively ana-lyzed, and the condition of medical history, Strains classification of fungi, risk factors, diagnosis and treatment, progno-sis were summarized and analyzed. Results The susceptible factors of lung fungal infection included chronic lung dis-eases and drug abuse and so on, including 32 cases of chronic obstructive pulmonary diseases (41.56%), 17 cases of tu-berculosis (22.08%), 11 cases of type 2 diabetes (14.29%), 7 cases of hypoalbuminemia (9.09%), 2 cases of thoracoto-my (2.60%), 3 cases of lung cancer and pulmonary fungi posthepatitic cirrhosis complicated with pulmonary fungal in-fection (3.90%), 3 cases of pulmonary fungi posthepatitic cirrhosis complicated with pulmonary fungal infection (3.90%), 2 cases of blood disease complicated with pulmonary fungal infection (2.60%), 49 cases of long time using of broad-spec-trum antibiotics (63.64%), 15 cases use the glucocorticoid (19.48%). The main fungal species was blastocystis, 47 cases of candida albicans (61.04%), 23 cases of candida glabrata (29.87%), 3 cases of tropical candida (3.90%), 4 cases of aspergillus (5.19%). They were mainly given the antifungal therapy after diagnosis, such as Fluconazole, Voriconazole, 5-Fluorine Cytosine, Amphotericin B, 55 cases (71.43%) were cured, 20 cases (25.97%) were improved, had a good over-all treatment effect. Conclusion Early and correctly diagnosis and treatment according to the strains of pulmonary fun-gal infection is the key to healing, so comprehensive treatment actively, improve the patients' immunity, eliminate risk factors associated with pulmonary fungal infection disease, timely application of antifungal drugs to intervene, can ob-tain satisfactory curative effect.
