肝衰竭并发曲霉感染的临床特征分析  

Clinical characteristics of liver failure complicated with aspergillus infection

作　　者：赵鸿[1] 王慧芬[1] 闫涛[1] 苏海滨[1] 林芳[1] 牟劲松[1] 

机构地区：[1]解放军302医院肝衰竭诊疗与研究中心,北京100039

出　　处：《海南医学院学报》2012年第1期48-51,共4页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020120013)~~

摘　　要：目的:研究肝衰竭合并曲霉感染的临床特征。方法:自1985年1月至2009年9月解放军三0二医院收治的肝衰竭并发真菌感染患者共681例,对其中83例合并曲霉感染患者的临床资料进行回顾性研究。结果:83例患者以中年男性为主,慢加急性(亚急性)和慢性肝衰竭多见,病因主要是HBV感染。腹腔是多数肝衰竭患者并发曲霉感染前最常见的细菌感染灶,细菌培养结果示半数以上的致病菌为革兰阴性杆菌,而抗生素的使用有起点高、疗程长、广谱抗生素联合应用等特点。曲霉感染的发生绝大多数为医院感染。曲霉最常侵犯的人体器官是肺,且所占比例远远高于其他部位。感染的曲霉菌属以烟曲霉为主,黑曲霉和黄曲霉相对少见。结论:肝衰竭患者病情危重,并发症多,治疗难度大。并发曲霉感染后,抗真菌治疗疗效差,患者病死率明显升高。Objective： The aim of this study is to analyze the clinical characteristics of patients infected with aspergillus.Methods：A total of 681patients with liver failure complicated with fungus infection that were enrolled into out hospital during January 1985 to September 2009,and retrospective study on the data of 81 cases,who had aspergillus infection were conducted. Results：most of the 83 patients were middle aged male suffering from suacute or chronic liver failure caused by HBV infection.Bacteria infection,more than half were gram-negative bacillus according to the culture result,could be found in peritoneal cavity.Patients infected with bacteria were often treated by combination of different antibiotics with a long course.Aspergillus infections were mainly nosocomial infection,mainly affect lung in human,Aspergillus fumigatus is more frequently involved,while Aspergillus niger and Aspergillus flavus infection is comparably rare.Conclusions：Patients with liver failure was in critical status with high mortality,considering the high incidence of complications,and difficulties in treatment,especially when Aspergillus occurred.

关 键 词：肝衰竭 真菌 曲霉 感染 

分 类 号：R735[医药卫生—肿瘤]