胆道闭锁术后真菌感染  

Fungous Infection after Kasai's Operation

作　　者：刘钧澄[1] 李桂生[1] 佘锦标[1] 冯大军[1] 冯运红[1] 潘翠玲[1] 

机构地区：[1]中山大学附属第一医院小儿外科,广州510080

出　　处：《实用儿科临床杂志》2007年第11期820-821,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨胆道闭锁手术后真菌感染发生的原因、危害性和诊治方法。方法对近14年来本科行Kasai手术的131例胆道闭锁患儿的临床资料进行分析。比较手术前、后浅层和深部组织发生真菌感染情况,统计术后真菌性胆管炎发生率。结果35例发生皮肤真菌感染或口腔鹅口疮。60例胆道造瘘患儿,从造瘘口收集物进行检查,19例为细菌感染,14例发生胆道真菌感染,其胆道排出物可见真菌。另5例发生细菌和真菌混合感染。1例发生真菌性脑脓肿,并致死亡。结论阻塞性黄疸手术后应用大量激素和广谱抗生素,可能是术后易发生真菌感染的原因。深层真菌感染可引起严重并发症,甚至死亡。胆管炎不仅可由细菌引起,也有可能是真菌感染所致。Objective To explore the cause, side effect, diagnosis and treatment of fungal infection after Kasai＇s operation. Method The clinical data were analyzed, including manifestation, sites and morbidity of fungal infection before and after operation on 131 patients with biliary atresia from Feb. 1989 to the end of 2002. Results Thirty -five cases with superficial fungal infection or mycolic stomatitis after Kasak＇s operation. Nineteen of 60 patients who underwent hepatic portoenterostomy with percatancous had bacterial cholangitis, and 14 of them had fungous cholangitis,and both bacterial and fungal infection were detected in 5 infants. In the meantime：l patient died of fungous brain abscess. Conclusions The cause of fungal infection of patients may be related to high dose hydrocortisone before operation and broad - spectrum antibiotic after Kasai＇s operation. Fungal infection in deep layer can result in serious complications of patients, even death. Not only bacterial, but also fungus is the pathogen of cholangitis.

关 键 词：胆道闭锁 胆管炎 真菌 

分 类 号：R726.5[医药卫生—儿科]