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目的:分析老年侵袭性肺部真菌感染的临床特点、易感因素及防治策略。方法:对2004年1月至2008年6月收治的78例老年侵袭性肺部真菌感染进行回顾性分析。结果:78例患者真菌培养获得真菌62株,其中白色念珠菌29株,占46.77%;非白色念珠菌33例,占53.23%。相关死亡率26.92%。氟康唑、两性霉素B及两药联用的有效率分别为53.57%、56.25%和88.88%。联合用药组和单药组比较,差异有统计学意义(P<0.05)。结论:氟康唑和两性毒素B是治疗侵袭性肺真菌感染的有效药物,联合应用氟康唑及两性霉素B较单药治疗更为有效。
Objective: To analyze the clinical features, predisposing factors and prevention and treatment strategies of elderly aggressive pulmonary fungal infection. Methods: A retrospective analysis of 78 elderly patients with invasive pulmonary fungal infection admitted from January 2004 to June 2008 was performed. Results: Totally 62 fungi were obtained from 78 patients, of which 29 were Candida albicans, accounting for 46.77%; 33 were non-Candida albicans, accounting for 53.23%. The related death rate was 26.92%. The effective rates of fluconazole, amphotericin B and the two drugs were 53.57%, 56.25% and 88.88% respectively. The difference between the combination group and the single drug group was statistically significant (P <0.05). Conclusion: Fluconazole and amphotericin B are effective drugs in the treatment of invasive pulmonary fungal infection. Combination of fluconazole and amphotericin B is more effective than monotherapy.