肝衰竭并发医院内真菌感染36例临床分析  

Clinical analysis of 36 liver failure patients with nosocomial fungal infection

作　　者：梁东[1] 

机构地区：[1]佛山市第一人民医院感染科,广东佛山528000

出　　处：《中国热带医学》2015年第12期1510-1512,共3页China Tropical Medicine

摘　　要：目的探讨肝衰竭并发医院内真菌感染的临床特点及预防、治疗对策。方法回顾性分析2010年1月—2015年6月收治的肝衰竭患者的临床资料。结果肝衰竭并发医院内真菌感染发生率为10.1%(36/357),住院超过40d者感染率17.0%,明显高于住院时间小于40 d者的6.9%(P<0.01);感染部位以肠道居多(65.9%),其次为下呼吸道(17.1%);病原菌以白色念珠菌为主(59.6%),其次为光滑念珠菌(14.9%);50%并发医院内真菌感染者外周血白细胞或中性分叶核粒细胞比例升高,38.9%出现不同程度发热;36例合并真菌感染者均接受过抗菌药物及侵入性操作;发生真菌感染的肝衰竭患者病死率55.6%,明显高于未发生感染真菌者的19.0%(P<0.01)。结论肝衰竭患者发生医院内真菌感染率和病死率高,白色念珠菌为主要病原菌,早期发现以及有效地治疗真菌感染是提高肝衰竭患者生存率的重要手段。Objective To investigate the clinical feature, prevention and treatment of nosocomial fungal infection in liverfailure patients. Methods Retrospective analysis of the clinical data was performed from January 2010 to June 2015.Results Nosocomial fungal infection rate in liver failure patients was 10.1%（36/357）. Nosocomial fungal infection rate inpatients who had been admitted for more than 40 days was 17.0% and the rate was significantly higher than that in less than 40days（6.9%）. Fungal infection in alimentary tract and lower respiratory tract accounted for 65.9% and 17.1%. Candida albicansinfection accounted for 59.6% and Candida glabrata for 14.9%. The infections at 50% had elevated white blood cell counts orneutrophil in peripheral blood, and 14 cases（38.9%） had fever. Broad- spectrum of antibiotics and invasive medicalmanipulation were used in all of 36 liver failure patients. The mortality rate in patients with fungal infection was 55.6%, and therate was significantly higher than that without fungal infection（19.0%）. Conclusion The nosocomial fungal infection rateand the mortality in liver failure patients are high. Candida albicans accounts for the most of the infections. Early detection andtreatment of fungal infection are important to increase the survival rate of patients with liver failure.

关 键 词：肝衰竭 医院内感染 真菌 

分 类 号：R575.3[医药卫生—消化系统]