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[摘要] 目的 探讨儿童重症监护室（PICU）深部真菌感染的发生特点、病原学种类及治疗情况，提高诊治水平。 方法 选取2009年1月～2011年6月PICU住院确诊为深部真菌感染的19例儿童为研究对象，回顾性分析其真菌感染的易感因素、病原学特点及抗真菌治疗效果。 结果 患儿基础疾病以肺部疾病最多见，占57.9%（11例）。易感因素有侵入性操作（19/19），使用广谱抗生素≥4 d（19/19），应用静脉营养（10/19）和应用呼吸机（9/19）。致病菌以白色念珠菌多见，占84.21%（16例），热带念珠菌2例，新型隐球菌1例。19例均给予抗真菌治疗。8例单用氟康唑（Flu），其余11例用二性霉素B脂质体（L—AMB）联合氟康唑（Flu）治疗。13例治愈，4例好转，2例死亡。 结论 PICU儿童深部真菌感染与多种易感因素有关，白色念珠菌是儿童深部真菌感染的常见病原，氟康唑（Flu）单用，或氟康唑（Flu）联合二性霉素B脂质体（L—AMB）是治疗儿童深部真菌感染的有效治疗方案。
[关键词] 儿童重症监护室；深部真菌感染；治疗；分析
[] C[文章编号] 1674—4721（2012）09（c）—0163—02
Analysis and treatment of invasive fungal infection in PICU
WANG Qi WANG Jianmin
Department of PICU， the First People''s Hospital of Shangqiu City in H
[Abstract] Objective To explore the clinical characteristics， fungal species and the treatment of deep fungal infection in PICU， and to enhance the level of diagnosis and treatment. Methods Nineteen children with deep fungal infection hospitalized in PICU from January 2009 to June 2011 were selected as object of study， predisposeng factors， pathogenic characteristics and treatment efficacy of fungal infection were retrospectively analyzed. Results The most common basal illness was lung disease， accounted for 57.9% （11 cases）. There were some predisposing factors such as invasive operation （19/19）， using of broad—spectrum antibiotics for more than 4 days （19/19）， intrenous nutrition （10/19） and mechanical ventilation （9/19）. The most pathogenic bacterium was candida albicans， accounted for 84.21% （16 cases）， 2 cases of candida tropicalis， 1 case of cryptococcus neoformans. 19 cases were treated with antifungal therapy. Fluroconazole（Flu）was used alone in 8 cases， Liposome Amphotericin（L—AMB） combined with Fluroconazole were used in 11 cases. 13 cases were cured， 4 cases were relieved and 2 cases were died. Conclusion Children invasive fungal infection relatives to lots of predisposing factors in PICU， the most pathogenic bacterium is candida albicans. Flu or L—AMB combined with flu is effective therapeutic schedule in the treatment of invasive fungal infection of children.
[Key words] PICU； Invasive fungal infection； Treatment； Analysis
近年来，由于PICU长时间广谱抗生素、糖皮质激素的使用，呼吸机及医源性侵入性操作的应用增多，PICU院内感染发病率也随之逐渐增多，深部真菌感染，尤其是肺部感染的发病率逐年上升，年龄小的患儿更易发生。因其临床表现不典型，真菌培养阳性率低，难以被确诊，以致临床常延迟或得不到治疗，病死率较高。本文将2009年1月～2011年6月在本院PICU住院并确诊为真菌肺炎的病例进行回顾性分析，探讨其临床分布特点、易感因素及治疗效果，现报道如下：
[关键词] 儿童重症监护室；深部真菌感染；治疗；分析
[] C[文章编号] 1674—4721（2012）09（c）—0163—02
Analysis and treatment of invasive fungal infection in PICU
WANG Qi WANG Jianmin
Department of PICU， the First People''s Hospital of Shangqiu City in H
源于：论文格式范文模板www.udooo.com
e''nan Province， Shangqiu476100， China[Abstract] Objective To explore the clinical characteristics， fungal species and the treatment of deep fungal infection in PICU， and to enhance the level of diagnosis and treatment. Methods Nineteen children with deep fungal infection hospitalized in PICU from January 2009 to June 2011 were selected as object of study， predisposeng factors， pathogenic characteristics and treatment efficacy of fungal infection were retrospectively analyzed. Results The most common basal illness was lung disease， accounted for 57.9% （11 cases）. There were some predisposing factors such as invasive operation （19/19）， using of broad—spectrum antibiotics for more than 4 days （19/19）， intrenous nutrition （10/19） and mechanical ventilation （9/19）. The most pathogenic bacterium was candida albicans， accounted for 84.21% （16 cases）， 2 cases of candida tropicalis， 1 case of cryptococcus neoformans. 19 cases were treated with antifungal therapy. Fluroconazole（Flu）was used alone in 8 cases， Liposome Amphotericin（L—AMB） combined with Fluroconazole were used in 11 cases. 13 cases were cured， 4 cases were relieved and 2 cases were died. Conclusion Children invasive fungal infection relatives to lots of predisposing factors in PICU， the most pathogenic bacterium is candida albicans. Flu or L—AMB combined with flu is effective therapeutic schedule in the treatment of invasive fungal infection of children.
[Key words] PICU； Invasive fungal infection； Treatment； Analysis
近年来，由于PICU长时间广谱抗生素、糖皮质激素的使用，呼吸机及医源性侵入性操作的应用增多，PICU院内感染发病率也随之逐渐增多，深部真菌感染，尤其是肺部感染的发病率逐年上升，年龄小的患儿更易发生。因其临床表现不典型，真菌培养阳性率低，难以被确诊，以致临床常延迟或得不到治疗，病死率较高。本文将2009年1月～2011年6月在本院PICU住院并确诊为真菌肺炎的病例进行回顾性分析，探讨其临床分布特点、易感因素及治疗效果，现报道如下：
1 资料与方法
1.1 一般资料
选取2009年1月～2011年6月在本院PICU住院确诊为深部真菌感染的19例儿童为研究对象。其中，男12例，女7例，年龄3个月～8岁。19例患儿均患有基础疾病，其中，重症肺炎8例，先天性心脏病合并肺炎3例，脓毒血症3例，肠梗阻并感染性休克1例，白血病合并感染1例，肾病综合征合并感染2例，慢性腹泻病合并感染1例。应用呼吸机治疗者9例，19例均应用广谱抗生素≥4 d。源于：论文例文www.udooo.com