恶性肿瘤患者疑似呼吸道真菌感染经验性治疗的初步研究  

Preliminary study of empirical therapy for malignant tumor patients with suspected respiratory tract fungal infection

作　　者：李向敏[1] 于天跃 张晓晔[1] 崔国元[1] 

机构地区：[1]中国医科大学附属盛京医院第四肿瘤科,辽宁沈阳110022 [2]葫芦岛市中心医院肿瘤内一科,辽宁葫芦岛125000

出　　处：《现代肿瘤医学》2016年第18期2958-2960,共3页Journal of Modern Oncology

基　　金：辽宁省自然科学基金(编号:2014021032)

摘　　要：目的:观察恶性肿瘤患者真菌感染的临床特点,探讨恶性肿瘤患者上呼吸道真菌感染的经验性治疗方法。方法:选取疑似上呼吸道真菌感染的住院患者27例,予以经验性氟康唑抗真菌治疗,并进一步根据真菌培养结果及患者症状改善情况,选择适当的抗真菌药物并观察疗效。结果:在27例患者真菌培养结果中,以白色念珠菌占比例最多,为89.6%。其中85%的病例出现白色拉丝黏痰的症状,最易合并的前四项危险因素有KPS≤50分、年龄>60岁、近期应用广谱抗生素以及长期卧床。经验性治疗后,有效17例,占62.9%,无效10例,其中7例死亡,占25.9%。结论:恶性肿瘤患者易合并真菌感染,致死率高,根据临床表现及化验结果尽早发现真菌感染,并予经验性治疗尤为重要。Objective： To observe the clinical symptoms of fungal infections in the malignant tumor patients and discuss the empirical treatment to the cancer patients with fungal infections in the upper respiratory. Methods： We selected 27 cases in the hospitalized patients of our hospital,who were suspected of fungal infection in the upper respiratory tract. These patients were given experimental antifungal therapy by using Fluconazole. According to the result of fungal culture and situation of the patients,we selected the appropriate antifungal medicines and observed the curative effect. Results： With the results of the sputum fungal culture of 27 cases,Endomyces albicans was the top by 89. 6%.85% of the cases appear the symptom of white sticky phlegm and the following top four risk factors： KPS≤50,age 60 years,using antibiotics recently and long- term bed ridden patients. The treatment was effective in 17 patients of all cases,accounting for 62. 9%. The treatment was ineffective in 10 cases included 7 deaths,accounting for 25. 9%.Conclusion： With the high mortality rate,diagnosing fungal infection as soon as possible and giving the patients empirical treatment is particularly important.

关 键 词：恶性肿瘤 真菌感染 经验性治疗 

分 类 号：R730.5[医药卫生—肿瘤]