血液病合并鼻-眶-脑型毛霉菌病6例临床分析

目的 探讨血液病合并鼻-眶-脑型毛霉菌病(M-ROC)的病例特点,提高对本病的认识及临床诊治水平.方法 回顾性分析2009-2015年收治的6例血液病合并M-ROC患者的临床资料,结合文献复习分析其临床特点、治疗及预后情况.结果 6例患者均为骨髓移植术后,2例合并粒细胞缺乏症.其中5例于症状出现后数天至数月行鼻内镜下病变清除术,1例行开放性手术清除病变组织.3例术中彻底清除病变组织,3例仅行局限性清除,患者分别于术后8d(1例)、1个月(1例)、2个月(2例)、6个月(2例)死亡.结论 早期诊断及手术治疗是提高血液病合并M-ROC患者生存率的关键.

Clinical analysis on 6 cases of hematological patients with rhino-orbital-cerebral mucormycosis

Objectives To explore the clinical characteristics of hematologic disease complicated by rhino-orbital-cerebral mucormycosis (HD-ROCM) and improve the understanding, diagnosis and treatment of M-ROC.Methods For mastering the clinical characteristics, treatment and prognosis of HD-ROCM, the medical records of 6 HD-ROCM patients admitted from 2009 to 2015 were analyzed retrospectively, and related literatures were also retrieved and reviewed.Results All the patients had bone marrow transplantation, 2 out of 6 patients had neutropenia, 5 had endoscopic debridement in a few days to several months after the onset of symptoms, and 1 had open debridement. 3 out of 6 achieved local debridement, and the other 3 had radical debridement. Out of them, one died 8 days postoperation, 1 died at 1 month, 2 at 2 months and 2 at 6 months.ConclusionEarly diagnosis and timely surgical treatment are the key points for improving the survival rate of HD-ROCM patients.