摘要
目的 探讨重症急性胰腺炎 (SAP)合并深部真菌感染 (DFI)的临床特点及防治对策。方法 回顾总结近 4a来本院收治 12 8例SAP的临床特征 ,按是否合并DFI进行比较分析。结果 4 8例合并DFI,死亡 2 1例 ,DFI发生率和死亡率分别为 37 5 %和 4 3 7% ;合并DFI者具有入院时APACHEⅡ评分高、住ICU及病程长、需长期留置各种导管和接受机械通气、肠外营养、抗酸剂及广谱抗生素治疗等特点 ;白色念珠菌为主要致病菌 ,常见感染部位分别为呼吸道、腹腔及泌尿道。结论 SAP为DFI高危人群 ,具有较高发生率及病死率 ,应采取防、治相结合的措施 ,包括加强支持治疗、降低高危易感因素。
Objectives To investigate the clinical character of severely acute pancreatitis(SAP) with deep fungal infection (DFI) and its therapeutic strategy.Methods We retrospectively analyzed and compared the clinical character in 128 cases of SAP with or without DFI within 4 years.Results There were 48 cases of SAP complicated with DFI and 21 cases died.The incidence and mortality of SAP with DFI were 37 5% and 43 7% respectively.Patients with DFI compared with patients without DFI had a higher APACHEⅡ score at admission,a longer hospital ICU stay and needed a longer time treatment with various catheter,mechanical ventilator,TPN,anti-acid drugs or broad spectrum antibiotics.The most common pathogen was Candida albicans and the most infected tissue and organ was the respiratory tract,abdomen cavity and urinary system.Conclusions Patients with SAP were at risk of DFI which had a high morbidity and mortality.It was important to carry out the prevention and treatment at the same time,which including enhancing supportive therapy,decreasing the risk factors,preventing the intestinal bacterial translocation and giving prophylactic antifungal drugs properly.
出处
《中国急救医学》
CAS
CSCD
北大核心
2004年第5期318-321,共4页
Chinese Journal of Critical Care Medicine
关键词
重症急性胰腺炎
深部真菌感染
治疗措施
Severely acute pancreatitis(SAP)
Deep fungal infection(DFI)
Therapeutic strategy
