摘要
目的探讨儿童血液系统恶性疾病合并侵袭性镰刀菌病的临床特点及其治疗方案,并进行文献复习。方法选择2016年7月15日,于中山大学孙逸仙纪念医院儿童血液病区住院治疗的1例骨髓增生异常综合征(MDS)合并侵袭性镰刀菌病的13岁女性患儿为研究对象,对其临床特点进行分析。文献复习设定检索策略为:以"恶性""血液系统疾病""侵袭性镰刀菌病""malignant""hematologic disease"及"invasive fuasriosis"为关键词,在PubMed数据库、中国生物医学文献服务系统(SinoMed)、中国知网(CNKI)、万方数据知识服务平台和维普中文科技期刊数据库进行相关文献检索,收集并分析检索到的血液系统恶性疾病合并侵袭性镰刀菌病的相关文献,检索年限设定为2010年1月1日至2016年12月31日。总结儿童血液系统恶性疾病合并侵袭性镰刀菌病的临床特点及其诊治方法。本研究符合2013年修订的《世界医学协会赫尔辛基宣言》的要求。结果 (1)根据患儿临床表现及相关实验室检查结果,诊断为MDS。化疗后,其胸部CT检查可见肺部浸润影,随后四肢、躯干出现紫红色硬结伴中央坏死,并且四肢出现多个皮下液性包块。皮肤活组织病理学检查、骨髓培养和包块引流物培养均提示镰刀菌感染,针对镰刀菌感染采取两性霉素B+泊沙康唑抗真菌治疗策略。随访患儿至2017年4月5日,因患儿原发基础疾病无法缓解,家属放弃治疗出院。(2)共计检索到国内外相关文献7篇,涉及21例血液系统恶性疾病合并侵袭性镰刀菌病患儿,其中男性患儿为12例,女性为9例;主要临床表现为持续性发热并且积极化疗+抗感染治疗无效,预后较差。21例患儿中,死亡为14例,治愈为7例。结论血液系统恶性疾病合并镰刀菌病患儿应早诊断,并且治疗血液系统恶性疾病的同时,给予有效和足量、足疗程的抗真菌药物治疗。两性霉素B联合泊沙康唑可作为治疗侵�
Objective To investigate clinical features and treatment of hematological malignancies combined with invasive fusariosis in children,and to review the literatures.Methods On July 15,2016,a 13-year-old girl with myelodysplastic syndromes（MDS）and invasive fusariosis who was hospitalized in the Department of Pediatrics,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University was chosen as study subject,and its clinical features were analyzed.With the following key words of ＂ malignant＂ ＂ blood system disease＂ and ＂invasive fusariosis＂ as Chinese key words,and ＂ malignant,hematologic disease＂ and ＂invasive fuasriosis＂ as English key words,the literature of hematological malignancies combined with invasive fusariosis were searched from Pubmed database,SinoMed,China National Knowledge Infrastructure（CNKI）, Wanfang Data Knowledge Service Platform,and VIP database.Literature retrieval time ranged from Janury 1,2010 to December 31,2016,and clinical features of searched literatures were summarized.This study was consistent with the requirements of World Medical Association Declaration of Helsinki revised in 2013.Results（1）This was a case report of MDS with invasive fusariosis based on clinical manifestations and related laboratory findings.After chemotherapy,there were pulmonary infiltrates and limbs,purplered nodules on the trunk with central necrosis,followed by multiple subcutaneous fluid masses on the extremities.Skin biopsy,bone marrow culture,and mass drainage culture all indicated Fusarium infection.Amphotericin B combined with posaconazole were given to the child.The child was followed up until April 5,2017,her families gave up treatment and discharged because the primary basic disease could not be relieved.（2） The results of setting a retrieval strategy to search relevant literatures showed that a total of 7 domestic and foreign literatures reported a total of 21 children with hematologic malignancies and invasive fusariosis.Among them,12 were male and 9 were female.The main clinica
作者
廖雄宇
邱坤银
吴若豪
黄科
方建培
周敦华
Liao Xiongyu;Qiu Kunyin;Wu Ruohao;Huang Ke;Fang Jianpei;Zhou Dunhua(Department of Pediatrics,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,Guangdong Province,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2018年第4期406-412,共7页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
广东省科技厅科技发展专项资金项目(2017A020215086)~~
