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目的 总结重症新生儿感染病例经用2种以上广谱抗生素治疗,持续用药10d以上合并深部真菌感染18例的住院结果。方法 对象 因重症肺炎、败血症住院,经用2种以上广谱抗生素治疗10d以上,病情无好转或加重的病例。诊断方法 咽拭子或气管分泌物直接涂片镜检或培养和/或血培养检出真菌。检测结果 直接镜检阳性10/18例(55.5%),培养与镜检阳性符合率70%,血培养阳性8/18例(44.4%)。治疗方法 氟康唑 口服按2～5mg/kg,每天1次服,疗程10～14天;静注按每次5～10mg/kg,隔天1次,经1～2周治疗,病情好转,改口服,总疗程14～28天。酮康唑或克霉唑每天50～100mg/kg,口服,疗程10～14天。住院结果 治愈9例(50%),显效1例(5.5%),有效3例(16.7%),无效5例(27.8%)。无效病例中以克霉唑口服2例,酮康唑口服3例。而氟康唑治疗均有效。结论 氟康唑为目前治疗深部真菌感染的有效药物,可用于新生儿病例,重症病例可先静注后口服
Objective To summarize the results of inpatients with severe neonatal infection treated with two or more kinds of broad-spectrum antibiotics for more than 10 days with deep fungal infection. Methods Subjects were hospitalized for severe pneumonia and sepsis, and were treated with more than two kinds of broad-spectrum antibiotics for more than 10 days without any improvement or aggravation of symptoms. Diagnostic methods Throat swabs or tracheal secretions Direct smear microscopy or culture and / or blood culture to detect fungi. The results of direct microscopy positive 10/18 cases (55.5%), culture and microscopy positive coincidence rate of 70%, blood culture positive 8/18 cases (44.4%). Fluconazole oral treatment by 2 ~ 5mg / kg, 1 day service, treatment for 10 to 14 days; intravenous injection of 5 ~ 10mg / kg every other day 1, after 1 to 2 weeks of treatment, the condition improved, Change oral, the total course of 14 to 28 days. Ketoconazole or clotrimazole 50 ~ 100mg / kg daily, oral, treatment of 10 to 14 days. Results of hospitalization were cured in 9 cases (50%), markedly in 1 case (5.5%), effective in 3 cases (16.7%) and ineffective in 5 cases (27.8%). Invalid cases, clotrimazole 2 cases, ketoconazole 3 cases orally. Fluconazole treatment were effective. Conclusion Fluconazole is currently an effective drug for the treatment of deep fungal infections and can be used in neonatal cases. Severe cases can be treated with intravenous