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重症急性胰腺炎合并深部真菌感染32例临床分析 被引量:2

Severe acute pancreatitis complicating deep fungal infection: a report of 32 cases
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摘要 目的 探讨重症急性胰腺炎(severe acute pancreatitis,SAP)并发深部真菌感染(deep fungal infection,DFI)的特点及防治. 方法回顾性分析1998年10月至2009年10月我科收治的135例SAP患者的临床资料,其中并发DFI的32例,男19例,女13例,平均年龄(56±5)岁.结果 本组死亡7例(占21.9%),32例平均住重症监护室时间(21±6)d、住院时间(78±14)d、治疗费用(13.5±0.7)万元.SAP合并DFI患者具有以下特点:病情重、病程长、需住重症监护室治疗、多需手术清除感染灶、需长期留置各种导管、接受气管插管机械通气、肠外营养及长期使用广谱抗菌素治疗等特点.结论 SAP合并DFI具有较高发生率及病死率.应采取防治结合的措施,如:恰当处理原发病,严格无菌操作,合理应用抗生素和预防性应用抗真菌药等,可降低SAP合并DFI的发生率、病死率. Objective To investigate the characteristics and prevention of deep fungal infection (DFI) complicated by severe acute pancreatitis (SAP). Methods Clinical data of 135 SAP cases admitted from Oct. 1998 to Oct. 2009 were studied, the prevention and management of SAP with DFI ( 32cases) were investigated, among them there were 19 males and 13 females. Results Seven patients (21.9%) died of these 32 cases. The SAP patients with DFI were of more critical condition, longer course and having to stay in ICU about (21±6) d, most needed surgical debridement, on long-term indwelling catheters, intubation and mechanical ventilation, parenteral nutrition, long-term use of broad-spectrum antibiotics. These patients remained in the hospital for about (78 ± 14) d. Conclusions DFI is a common complication in SAP cases causing a significant mortality hence necessitating comprehensive prevention and control measures such as proper handling of the original disease, aseptic operation, prophylactic antibiotics and antifungal agents, which can reduce the incidence and mortality of SAP with DFI.
出处 《中华普通外科杂志》 CSCD 北大核心 2010年第11期886-888,共3页 Chinese Journal of General Surgery
关键词 胰腺炎 急性坏死性 感染 真菌 Pancreatitis, acute necrotizing Infection Fungi
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