氟康唑预防实体瘤患儿真菌感染临床效果分析  

Clinical efficacy of Fluconazole in prevention of solid fungal infection in children with solid tumor

作　　者：朱霞[1] 张伟令[1] 黄东生[1] 王一卓[1] 张谊[1] 周燕[1] 韩涛[1] 李静[1] 胡慧敏[1] 文圆[1] 李凡[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科,北京100176

出　　处：《中国医学前沿杂志（电子版）》2017年第11期66-68,共3页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨氟康唑在预防实体瘤患儿真菌感染中的临床效果。方法选取2006年5月至2016年6月本院收治的Ⅳ期实体瘤患儿67例为研究对象,按照随机数表法将患儿分为观察组(31例)和对照组(36例)。两组患儿均接受化疗,观察组患儿骨髓抑制期采用氟康唑早期经验性治疗,对照组患儿在临床发现口腔真菌感染后(鹅口疮)再行抗真菌治疗。比较两组患儿化疗后骨髓抑制期发热情况和造血功能恢复时间、真菌感染发生情况和病原学检查结果、发生真菌感染患儿的治疗情况和预后。结果两组患儿发热持续时间和造血功能恢复时间均有显著差异(t=4.8290,P=0.0000;t=12.8151,P=0.0000),发热患儿占比组间无明显差异(χ~2=0.2114,P=0.6457)。两组患儿感染率比较具有显著差异(χ~2=4.1761,P=0.0410)。观察组中2例患儿发生真菌感染,对照组中9例患儿发生真菌感染,经治疗后很快好转,平均症状消失时间为3~5天,复查血培养阴性,骨髓抑制恢复后进入下一阶段治疗。结论氟康唑可以有效降低实体瘤患儿化疗后骨髓抑制期真菌感染的发生率,对于减轻患儿痛苦、提高临床缓解率、改善患儿预后均具有较高的临床价值。ObjectiveTo investigate the clinical eficacy of Fluconazole in the prevention of fungal infection in children with solid tumors. MethodA total of 67 children with stage Ⅳ solid tumors in our hospital from May 2006 to June 2016 were selected as the study subjects. They were divided into observation group （31 cases） and control group （36 cases） according to the random number table method. The two groups of children received chemotherapy, observation group children were treated with Fluconazole in the early stage of bone marrow suppression, while control group children received antifungal therapy after oral fungus infection. The fever and hematopoietic function recovery time, the incidence of fungal infection and the results of etiological examination, the treatment and prognosis of children with fungal infection were compared between the two groups after chemotherapy. ResultThere were significant differences in the duration of fever and the recovery time of hematopoietic function in both groups （t = 4.8290, P = 0.0000; t = 12.8151, P = 0.0000）. There was no significant difference in the number of fever cases between the two groups （χ2=0.2114, P=0.6457）. The incidence of infection in the two groups was significantly different （χ2=4.1761, P=0.0410）. 2 cases of children in observation group had fungal infection and were improved after treatment. 9 cases of children in control group developed fungal infection, and all the treatments improved. Oral thrush improved rapidly after treatment, and the symptoms disappeared on average 3 ～ 5 days. ConclusionFluconazole can effectively reduce the incidence of mycosis fungal infection in children with solid tumors after chemotherapy, which has a high clinical value for alleviating pain, improving clinical remission rate and improving children＇s prognosis.

关 键 词：氟康唑 实体瘤 真菌感染 

分 类 号：R730.5[医药卫生—肿瘤]