造血干细胞移植患儿感染播散性阿萨希毛孢子菌的护理  

Nursing care of disseminated Trichosporon asahii infection in aplastic anemia children undergoing hematopoietic stem cell transplantation

作　　者：潘世平[1] 张璇[1] 肖洋[1] 刘晓娟[1] 孟祥菊[1] 刘安娜[1] 

机构地区：[1]空军总医院血液移植病房,北京100142

出　　处：《中华医院感染学杂志》2015年第8期1901-1902,共2页Chinese Journal of Nosocomiology

基　　金：军队临床高新技术基金资助项目(2010gxjs049)

摘　　要：目的探讨造血干细胞移植患儿发生播散性阿萨希毛孢子菌感染的预防和防护措施,为临床治疗提供参考依据。方法调查分析2012年1月1例7岁女性再生障碍性贫血患儿在行造血干细胞移植过程中发生阿萨希毛孢子菌和白色假丝酵母菌感染临床资料及护理措施效果。结果该例重型再生障碍性贫血患儿移植前长期应用激素、环孢素等免疫抑制剂,移植后第7天,患儿处于粒细胞缺乏期,出现高热、感染性休克症状,4次血培养均见阿萨希毛孢子菌和白色假丝酵母菌,诊断阿萨希毛孢子菌和白色假丝酵母菌败血症,经过伏立康唑、两性霉素B联合抗真菌治疗和精心护理,患儿体温正常,血像、骨髓像逐渐恢复。结论有针对性的护理措施和有效的治疗方法是救治造血干细胞移植过程中并发播散性阿萨希毛孢子菌感染成功的关键。OBJECTIVE To investigate prevention and protection of disseminated Trichosporon asahii infection in children undergoing hematopoietic stem cell transplantation.METHODS The clinical data and nursing care experience was analyzed of the first case of dissenminated T.asahii and Candida albicans infections in a 7-year-old girl suffered from severe aplastic anemia who underwent hematopoietic stem cell transplantation in Jan.2012 in our hospital.RESULTS This patient with severe aplastic anemia had long history of application of immunodepressants such as hormones and cyclosporin before stem cell transplantation.At the 7days after hematopoietic stem cell transplantation,she was neutropenic and suffered form high fever and septic shock.T.asahii and C.albicans were repeatedly demonstrated in four blood culture and she was diagnosed with T.asahii and C.albicans sepsis.After treatment with voriconazole and amphotericin B combined with antifungal therapy and careful nursing,her body temperature went normal and her hemogram and bone marrow analysis gradually recovered.CONCLUSION The special nursing and effective treatment are crucial for successful treatment of disseminated T.asahii infection during hematopoietic stem cell transplantation.

关 键 词：阿萨希毛孢子菌 造血干细胞移植 护理 

分 类 号：R181.32[医药卫生—流行病学]