小剂量氟康唑预防早产儿侵袭性真菌感染的效果观察  

Effect of small dose of fluconazole on preventing invasive fungal infection in premature infants

作　　者：杨庆南[1] 

机构地区：[1]上海交通大学医学院附属新华医院新生儿科,上海200092

出　　处：《中国妇幼健康研究》2017年第11期1384-1386,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨小剂量氟康唑预防早产儿真菌性败血症的临床疗效和安全性。方法将2015年1月至2017年1月在上海交通大学医学院附属新华医院产科出生胎龄在28~34周的早产儿160例收入新生儿重症监护室(NICU),随机分为实验组(80例)和对照组(80例),均给予两组早产儿常规治疗和护理;在此基础上对实验组患儿进行小剂量(3.0mg/kg)氟康唑静滴,静滴4周后比较两组预防真菌感染的效果以及肝功能异常的发生率。结果两组早产儿在性别、胎龄、体重、5分钟Apgar评分、运用广谱抗生素、激素、经外周静脉置入中心静脉导管(PICC)、肠外营养、机械通气等方面均无显著性差异(均P>0.05)。实验组的真菌性败血症确诊率显著低于对照组(χ~2=12.68,P<0.05);两组的病死率及支气管肺发育不良(BPD)、视网膜屏(ROP)、新生儿坏死性小肠结肠炎(NEC)等患病率比较均无显著性差异(均P>0.05);实验组的住院时间、住院费用、出院时患儿体重均稍高于对照组,但两组间比较均无显著性差异(均P>0.05)。两组患儿治疗后的直接胆红素、谷丙转氨酶、谷草转氨酶水平分别低于治疗前(t值分别为3.25、4.36、5.22,均P<0.05),处于正常水平,两组治疗后的直接胆红素、谷丙转氨酶、谷草转氨酶水平比较均无显著性差异(均P>0.05)。实验组的鹅口疮、红臀及真菌性眼炎的患病率和真菌性败血症确诊例数显著低于对照组,差异均具有统计学意义(χ~2值分别为4.53、6.11,均P<0.05)。结论小剂量氟康唑运用于早产儿,可显著降低其真菌败血症的感染率,且安全性较高。Objective To explore the clinical efficacy and safety of small dose of fluconazole on preventing fungal septicemia in premature infants.Methods A total of 160 premature infants with gestational age of 28-34 weeks delivered in obstetrics department of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine and admitted in neonatal intensive care unit（NICU）from January 2015 to January 2017 were selected and divided randomly into experimental group（80 cases）and control group（80 cases）.Infants in two groups were given routine treatment and nursing,and infants in the experimental group were treated with intravenous infusion of small dose of fluconazole（3.0 mg/kg）additionally.Effect on fungal infection prevention and incidence of liver function abnormality were compared between two groups after 4 weeks of fluconazole intravenous infusion.Results There was no significant difference in gender,gestational age,weight,5 min Apgar score,use of broad-spectrum antibiotics and hormone,peripherally inserted central catheter（PICC）,parenteral nutrition and mechanical ventilation between two groups（all P〈0.05）.Diagnosis rate of fungal septicemia in the experimental group was significantly lower than that in the control group（χ~2=12.68,P〈0.05）.Difference in fatality rate,incidences of bronchopulmonary dysplasia（BPD）,retina screen（ROP）,neonatal necrotizing enterocolitis（NEC）between two groups was not significant（all P〈0.05）.Hospital stay,hospital expenses,and weight of infants at discharge in the experimental group were slightly lower than those in the control group,but the differences had no statistical significance（all P〈0.05）.Levels of direct bilirubin,alanine aminotransferase and aspartate aminotransferase in two groups after treatment were lower than thsoe before treatment（t value was 3.25,4.36 and 5.22,respectively,all P〈0.05）,and they were in normal range.Levels of direct bilirubin,alanine aminotransferase and aspartate aminotransferase in two

关 键 词：小剂量氟康唑 早产儿 真菌性败血症 预防效果 

分 类 号：R722.6[医药卫生—儿科]