肝衰竭合并真菌感染的调查分析  

Liver Failure Complicated with Fungous Infection:A Retrospective Study

作　　者：苏海滨[1] 王慧芬[1] 林芳[1] 许海苗[1] 赵鸿[1] 李雷[1] 闫涛[1] 牟劲松[1] 李晨[1] 

机构地区：[1]解放军302医院肝衰竭治疗研究中心,北京100039

出　　处：《中华医院感染学杂志》2009年第13期1664-1667,共4页Chinese Journal of Nosocomiology

摘　　要：目的回顾性分析肝脏疾病及肝衰竭患者并发真菌感染的特点。方法以1986-1990年、1991-1995年、1996-2000年及2001-2005年为不同阶段,对各阶段肝衰竭并发真菌感染的发病情况、抗菌药物及激素的使用情况、真菌感染的类别和部位以及预后进行统计和评价。结果在475例真菌感染病例中,终末期肝病占所有病例的82.6%,病因以乙型肝炎病毒感染最为常见,占所有病例68.8%,真菌感染以医院感染为多见,占所有病例的80.9%,各阶段真菌医院感染和社区获得性感染发生率基本相同;真菌感染前,抗菌药物和激素的使用分别占所有病例的88.8%和48.0%,各阶段抗菌药物的使用差异无统计学意义,激素的使用逐年降低;真菌感染的类别以假丝酵母菌属为多见,感染部位较多见的为肺和口咽部;真菌感染及基础疾病的治愈好转率逐年提高,且基础疾病治愈好转率与真菌治愈好转率呈正相关。结论终末期肝病易并发真菌感染,假丝酵母菌属引起的感染最为多见,肺和口咽部为常见感染部位,重视抗真菌治疗对肝衰竭患者的预后十分重要。OBJECTIVE To study the featu.re of liver disease and liver failure complicated with fungous infection. METHODS The patients with liver disease complicated with fungous infection were collected form 1986 to 2005. The time was divided into four stages：from 1986 to 1990, from 1991 to 1995, from 1996 to 2000 and from 2001 to 2005. All patients with liver failure complicated with fungous infection in different stages were investigated for the incidence, the use of antibiotics and corticosteroids, the category and site of fungous infection and prognosis. RESULTS End-stage liver disease accounted for 82.6% and HBV infection was the main etiology in 475 cases of fungous infection. Fungous infection occurred mainly in hospital Hospital acquired infection and community acquired infection were similar in different stages. The use of antibiotics and corticosteroids accounted for 88.8% and 48% in all patients before fungous infection, respectively. The use of antibiotics had no difference and the use of corticosteroids decreased in different stages. Candida were the main infection strains and the lungs and pharynx oralis were the main infection sites. The rate of healing and improvement of fungous infection and underlying diseases increased year by year. Healing and improvement rate of underlaying disease positively correlated with that of fungous infection. CONCLUSIONS End-stage liver disease patients are susceptible to fungous infection and Candida are the common infection strains. Lungs and pharynx oralis are the common infection sites. Anti-fungous therapy is important in the treatment of liver failure complicated with fungous infection.

关 键 词：肝衰竭 感染 真菌 

分 类 号：R181.32[医药卫生—流行病学]