侵袭性肺部真菌感染68例临床分析

目的 探讨侵袭性肺部真菌感染(IPFI)的临床特征与高危因素及其诊断和治疗。方法 回顾性分析2007年1月至2011年3月我院68例IPFI患者的临床资料。结果 68例患者平均年龄为(53.2±10.6)岁,痰真菌培养中白色念珠菌属占首位(共36株,52.94％),其次是曲霉菌(18株,26.47％)和隐球菌(10株,14.71％),原发性IPH以肺隐球菌为主。严重的基础疾病、长期联合应用抗生素、糖皮质激素应用成为IPFI的主要危险因素。68例IPFI经抗真菌治疗痊愈或好转47例,未愈7例,死亡14例。结论 采取支持疗法,治疗原发疾病、减少侵入性诊疗、合理使用抗菌药物和激素、及时抗真菌治疗等措施,能有效降低IPH的发病率和病死率。

Clinical analysis of 68 patients with invasive pulmonary fungal infection

Objective To investigate the clinical features and high risk factors of invasive pulmonary fungalinfection(IPFI) to facilitate its diagnosis and treatment.Methods A retrospective investigation on the clinical data from 68 cases of IPFI patients in our hospital's data banks between Jan.2007 and Mar.2011 was performed.Results The average age of 68 patients was 61 years old.Candida albiacns(36 cases ,52.94％) was the major pathogen for the infection, and the next was aspergillus species(18 cases, 26.47％) and then cryptococcus species(10 cases, 14.71％) .For the primary IPFI,cryptococcus species was the first cause of infection.The main risk factors included severe underlying disease, long-term joint use of antibiotics as well as glucocorticoid usage.Fourty-seven of the 68 cases were cured or improved, 7 were unimproved and 14 died.Conclusion Effective measures to reduce the morbidity and mortality include positive supportive care,curing underlying disease, avoiding invasive surgical procedures and timely and reasonable antibiotics, antifungal and glucocorticoid drugs.