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目的探讨老年肺结核继发肺部真菌感染的危险因素、临床特点及诊治方法。方法回顾性分析2004—2008年80例老年肺结核患者入院时常规真菌检测。对肺部真菌感染的相关基础疾病、病原菌分类、药敏状况及治疗结果进行统计分析。结果老年肺结核继发肺部真菌感染病史长,均有基础疾病,均用过抗生素。以白色念珠菌为主,占70%且耐药率低。随着肺内病变的増多,真菌感染的发生率増加,以肺内病变占据≥3个肺野多见(占75%)。真菌感染易发生在病变以纤维化为主的肺结核患者(占80%)。结论老年肺结核较易继发肺部真菌感染,应加强抗生素及肾上腺皮质激素的规范应用,以减少真菌感染及其耐药率的发生,有利结核病控制及减少死亡。
Objective To investigate the risk factors, clinical features, diagnosis and treatment of pulmonary fungal infection in elderly patients with pulmonary tuberculosis. Methods Retrospective analysis of 80 cases of elderly patients with pulmonary tuberculosis admitted to the hospital during 2004-2008 conventional fungal detection. On the basis of lung fungal infection related diseases, pathogenic bacteria classification, drug susceptibility status and treatment results were statistically analyzed. Results Elderly pulmonary tuberculosis secondary to a long history of fungal infections, both have underlying diseases, have used antibiotics. Candida albicans, accounting for 70% and low resistance rate. With the increase of intra-lung lesions, the incidence of fungal infections increased, with lung lesions occupy ≥ 3 lung fields more common (75%). Fungal infections are predominantly pulmonary tuberculosis (80%) in patients with fibrosis. Conclusion Elderly pulmonary tuberculosis is more likely to be secondary to fungal pulmonary infection, should be to strengthen the normative application of antibiotics and adrenal cortex hormones in order to reduce the incidence of fungal infections and drug resistance, tuberculosis control and reduce deaths.