摘要
目的探讨重症监护病房(ICU)儿童肺部真菌感染危险因素及防治对策。方法回顾性分析武汉市儿童医院ICU2003年1月～2007年1月40例肺部真菌感染患儿抗生素、激素和侵入性操作使用情况及其防治与转归。结果40例患儿均有长期使用广谱抗生素和糖皮质激素史,75%患儿接受过侵入性操作或治疗,平均住院时间长(37.8d)。其临床症状及体征不典型,影像学检查无特异性。病原以白色念珠菌居首,占80%,曲霉菌属次之。治愈35例(87.5%),死亡5例(12.5%)。结论长期使用广谱抗生素及糖皮质激素是儿童肺部真菌感染主要危险因素。合理应用抗生素和糖皮质激素,减少不必要侵入性操作,加强微生态免疫营养支持,及时用高效抗真菌药物,有助于降低肺部真菌感染的发生。
Objective To investigate the risk factors of pulmonary fungal infection in intensive care unit （ ICU）, and discuss the strategy of prevention and treatment. Methods Forty children with pulmonary fungal infection in ICU of Wuhan Children＇s Hospital from Jan. 2003 to Jan. 2007 were analyzed retrospectively, including primarily diseases, application of antibiotics, adrenal cortical hormone and virulence operation, therapy and turnover. Results All children were accepted the therapies of broad spectrum antibiotics and glueocortieoids for long time before definite diagnosis of pulmonary fungal infection. Seventy - five percent children were received invasive operations or therapies. Their average time of stayed in hospital was 37.8 d. The clinical symptoms and imaging examinations were untypical. Blastomyees albieans was the main pathogen. After the antifungal agents and supportive treatment used in time,35 cases （87.5%） were cured and 5 eases （12.5%） died. Conclusions The major risk factors of children pulmonary fungal infection are long - time use of broad spectrum antibiotics and glueoeortieoids. The pulmonary fungal infection ean decrease by rational use of broad spectrum antibioties and glueoeortieoids,deereasing the unneeessary invasire operations, strengthening the supportive therapies of micro - ecosystem, and applying the antifungal agents in time.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第16期1247-1248,共2页
Journal of Applied Clinical Pediatrics
关键词
肺部感染
真菌性
重症监护病房
儿童
pulmonary fungal infection
intensive care unit
child
