摘要
目的探讨肝胆外科病房深部真菌感染的危险因素及诊治措施。方法回顾性分析2003年1月～2006年12月期间肝胆外科病房深部真菌感染58例患者的临床资料。结果58例共分离出69株菌株,其中念珠菌56株,曲霉菌13株,主要构成有白色念球菌44.9%、光滑念珠菌17.4%、热带念珠菌13%、克柔念珠菌2.9%及其他念珠菌,曲霉菌18.8%。深部真菌感染的疾病主要有重症急性胰腺炎、严重的胆管感染、肝胆胰恶性肿瘤、肝移植。长期的广谱抗生素使用、中心静脉置管、TPN的使用、肝功能障碍、皮质类固醇激素使用、高龄是真菌感染高危因素。结论深部真菌感染是肝胆外科病房常见的并发症,及时合理的手术、无菌操作、保护肠屏蔽功能、合理使用抗生素和皮质类固醇激素可以改善深部真菌感染患者的预后。
Objective To investigate the risk factors and prevention methods of deep fungus infection in hepatobiliary surgical ward. Methods The clinical materials of 58 patients infected with nosocomial candida from January 2003 to December 2006 were retrospectively analyzed. Results Sixth-nine strains of fungal were cultivated from in 58 specimens, nosocomial candida were 56 strains and aspergillus candida were 13 strains. The infection rate of candida albicans was 44.9%, candida glabrata 17.4%, eandida tropicalis 13 % ,candida krusei 2.9 %, fumigatus 18.8 %. Patient with the highest infection rate were severe acute pancreatitis, acute obstrvctive cholangitis,hepatobiliary and pancreaticc areinoma liver transplantation. Long term broad-spectrum antibiotic usage,remaining CVP,TPN usage,hyperglycaemia,Cortisol useage,senility were the risk factors of fungal infection. Conclusion The deep fungal infection in hepa- tobiliary surgical ward is a severe complication;timely and reasonable operations, nonbacterial operation ,gut barrier protection, right used antibiotic and cortisol are significant measures to prevent deep fungal infection.
出处
《四川医学》
CAS
2008年第8期1016-1017,共2页
Sichuan Medical Journal
关键词
深部真菌感染
肝胆外科病房
危险因素
deep fungal infection
hepatobiliary surgical ward
the risk factors
