老年糖尿病患者医院感染真菌性肺炎临床分析

目的对老年糖尿病患者医院感染真菌性肺炎的临床特点进行综合分析。方法对2004年1月~2008年12月住院的32例老年糖尿病患者医院感染真菌性肺炎的病例资料进行临床研究。结果对32例患者的临床综合分析显示,痰培养中检出白色假丝酵母菌14株(43.75%),热带假丝酵母菌11株(34.38%),这两种真菌为主要的致病菌,氟康唑对93.75%的真菌有效;胸部X线缺乏特异性,但片状阴影(62.50%)和团絮状阴影(37.50%)占多数;87.50%的患者曾经应用2种抗菌药物且10 d;81.25%的患者同时合并3种的并发症;65.63%的患者口腔黏膜发现白色菌斑;患者的好转治愈率为68.75%,病死率为31.25%。结论老年糖尿病患者医院感染真菌性肺炎病死率高,治愈的关键是及早确诊、及早治疗,氟康唑可作为首选用药和预防用药。

Gerontal Diabetics Complicated with Hospital Infection of Mycotic Pneumonia:a Clinical Analysis

OBJECTIVE To analysis the clinical characteristics of senile diabetics complicated with hospital infection of mycotic pneumonia.METHODS A clinical study was made on 32 cases of senile diabetics complicated with hospital infection of mycotic pneumonia in hospital from Jan,2004 to Dec,2008.RESULTS Among these 32 Datients,Candida mycoderma(about 43.75%)and C.tropicalis(about 34.38%)were the major pathogens.About 93.75% of them are sensitive to Fluconazol(Diflucan).Their chest x-ray films weren't characteristic.Lamellar shadows(62.5%)and pathy shadows(37.5%)were found on chest x-ray films.These patients had kinds of complications that 81.25% of them had more than 3 kinds.Their blood sugar didn't control well.87.5% of these patients had ever taken more than 2 kinds of antibiotics over 10 days. 65.63% of them had bacteria plaques in their oral cavities.Improvement rate of these patients was 68.75% and mortality rate was 31.25%.CONCLUSIONS Senile diabetics complicated with hospital infection of mycotic pneumonia have high mortality rate.The key point to outcome is to make a early diagnosis and treat them as early as possible.Fluconazol can be for medication.