人工肝治疗重症肝病并发侵袭性真菌感染临床分析  

Clinical analysis of artificial liver in the treatment of severe liver disease complicated with invasive fungal infection

作　　者：苏倩[1] 张莉[1] 夏玲玲[1] 郜玉峰[1] 李家斌[1] Su Qian;Zhang Li;Xia Lingling;Gao Yufeng;Li Jiabin(Dept of Infectious Disease,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥230022

出　　处：《安徽医科大学学报》2022年第8期1300-1304,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽高校(自然)科学研究项目重点项目(编号:KJ2021A0305);安徽医科大学校科研基金项目(编号:2020xkj179)。

摘　　要：目的研究人工肝治疗重症肝病并发侵袭性真菌感染(IFI)的发病率、临床特征、治疗方案等。方法回顾性分析重症肝病患者的临床资料,根据是否并发IFI分为观察组和对照组,根据诊断标准将观察组分为临床诊断组和拟诊组,比较各组临床特征。结果228例患者纳入研究,观察组22例,对照组206例。两组住院天数、使用糖皮质激素>7 d、白细胞计数差异有统计学意义(P<0.05)。IFI发生率为9.65%(22/228),临床诊断组12例,拟诊组10例,常见感染部位为呼吸道(22,100%)。结论伏立康唑治疗重症肝病并发IFI安全有效。存在IFI高危因素的患者,如出现不能用基础疾病解释的TBil回升,应警惕并发IFI。Objective To study the incidence,clinical characteristics and treatment plans of artificial liver in the treatment of severe liver disease complicated with invasive fungal infection(IFI).Methods The clinical data of patients with severe liver disease were retrospectively analyzed,and they were divided into observation group and control group according to whether they were complicated with IFI.The observation group was divided into clinical diagnosis group and proposed diagnosis group according to diagnostic criteria,and the clinical characteristics of each group were compared.Results 228 patients were enrolled in the study,22 in the observation group and 206 in the control group.The hospitalization days,use of glucocorticoid for more than 7 days and WBC count between the two groups were statistically significant(P<0.05).The incidence of IFI was 9.65%(22/228),including 12 cases in the clinical diagnosis group and 10 cases in the proposed diagnosis group.The common infection site was respiratory tract(22,100%).Conclusion Voriconazole is safe and effective in the treatment of severe liver disease complicated with IFI.Patients with high-risk factors of IFI should be alert to concurrent IFI if TBil rebound that cannot be explained by basic diseases.

关 键 词：人工肝 重症肝病 侵袭性真菌感染 

分 类 号：R575.1[医药卫生—消化系统]