重症肝病合并医院真菌感染60例临床分析 FREE

目的探讨重症肝病患者医院真菌感染的临床特点。方法采用回顾性调查方法对 60例重症肝病合并医院真菌感染患者的临床资料及相关因素进行分析。结果同期住院重症肝病患者485例，其中60例(12.37%)发生医院真菌感染83例次(17.11%)。感染部位以肠道为主，占50.60%；其次为口腔(25.30%)、下呼吸道(9.64%)、腹腔(7.23%)、泌尿道(4.82%)和血液(2.41%)。 感染菌种以白假丝酵母菌为主，占61.67%；其次为近平滑假丝酵母菌，占16.67% 。60例重症肝病合并医院真菌感染者中死亡34例(56.67%)，与真菌感染直接相关2例(3.33%)；而未发生真菌感染的60例对照者中死亡19例(31.67%)，两组病死率差异有高度显著性(χ2＝7.60，Ｐ<0.01)。结论重症肝病患者发生医院真菌感染预后差，病死率极高。预防和治疗医院真菌感染需采取综合措施。

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Objective To evaluate clinical characteristics of nosocomial acquired fungal infection in patients with severe hepatitis. Methods Clinical data and related factors of fungal infection in 60 patients with severe hepatitis were analysed retrospectively. Results Four hundred and eighty-five severe hepatitis patients were hospitalized during the same period, 60 patients （12. 37%） developed 83 （17. 11%） cases of nosocomial fungal infection. The main infection site was intestinal tract （50. 60%）, followed by oral （25. 30%） , lower respiratory tract （9. 64%）, abdominal cavity （7. 23%） , urinary tract （4. 82%） and blood （2.41%） . The main pathogen was Candida albicance （61. 67%） , the next was Candida parapsilosis （16. 67%）. Thirty four of 60 （56. 67%） severe hepatitis patients died, 2 （3. 33%） were directly related with fungal infection; among 60 patients without fungal infection in control group , 19 （31.67%） died, there was significant difference in mortality between two groups（X^2 = 7. 60, P〈0. 01 ）. Conclusion The prognosis of patients with severe hepatitis complicating with fungal infection is poor, and mortality is high. Comprehensive measures should be adopted for treating nosocomial acquired fungal infection.