论文部分内容阅读
目的分析早产儿侵袭性真菌感染的高危因素、临床特征,观察两性霉素B脂质体治疗的有效性和安全性。方法回顾性分析21例侵袭性真菌感染早产儿的临床资料,根据临床特点、实验室检查确诊病例10例,临床诊断11例。应用两性霉素B脂质体治疗,剂量由0.1mg.kg-1.d-1开始,后每天或隔天加0.1mg.kg-1,每周复查1,3-β-D葡聚糖,结合临床继续增加至1～3mg.kg-1.d-1。同时每周监测肝肾功能及血常规。结果早产儿侵袭性真菌感染的高危因素是低胎龄儿、极低出生体质量儿、使用中心静脉导管、胃肠外营养、气管插管及长期应用抗生素。临床特征非特异性,各种体液培养以白色念珠菌为主;血1,3-β-D葡聚糖检测均>1500pg.L-1。本组治愈17例,有效2例,放弃、死亡各1例;未见明显不良反应。结论NICU中侵袭性真菌感染发病率日益增高,应重视其发病高危因素,血1,3-β-D葡聚糖监测非常必要,两性霉素B脂质体治疗早产儿侵袭性真菌感染安全、有效。
Objective To analyze the risk factors and clinical features of invasive fungal infection in premature infants and to observe the efficacy and safety of amphotericin B liposome therapy. Methods The clinical data of 21 cases of invasive fungal infection in preterm infants were retrospectively analyzed. According to the clinical features, 10 cases were confirmed by laboratory tests and 11 cases were diagnosed clinically. Application of amphotericin B liposome treatment, the dose starting from 0.1mg.kg-1.d-1, after every day or the next day plus 0.1mg.kg-1, weekly review of 1,3-β-D-glucan , Combined with clinical continued to increase to 1 ~ 3mg.kg-1.d-1. At the same time weekly monitoring of liver and kidney function and blood. Results Risk factors for invasive fungal infection in preterm infants were low-gestational age infants, very low birth weight infants, central venous catheters, parenteral nutrition, intubation and long-term antibiotics. Clinical characteristics of non-specific, a variety of body fluids to Candida albicans; blood 1,3-β-D-glucan were> 1500pg.L-1. This group cured 17 cases, 2 cases effective, give up, 1 case of death; no obvious adverse reactions. Conclusion The prevalence of invasive fungal infection in NICU is increasing day by day. High risk factors should be emphasized in the pathogenesis of NICU. Blood 1,3-β-D glucan monitoring is very necessary. Amphotericin B liposomes are safe for invasive fungal infection in premature infants, effective.