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目的:对重症监护病房(ICU)重症患者肺部真菌感染的临床特点进行系统分析,以期为临床治疗提供更多的参考数据。方法:回顾分析本院2013年1月-2014年6月收治的145例发生肺部真菌感染的ICU重症患者的临床资料,并就其临床感染症状、体征、真菌种类进行统计分析,并就ICU引发患者肺部真菌感染的相关危险因素进行系统分析。结果:145例ICU重症患者出现症状与体征多以发热为主,依次为肺部湿啰音、痰量增多,黏稠、呼吸急促等。经痰液、肺部分泌物、血液标本检测,共分离真菌156株;其中白色假丝酵母菌居首(52.6%),其次为热带假丝酵母菌(17.3%),第三为光滑假丝酵母菌(11.5%)。引发ICU重症患者肺部真菌感染危险因素多集中于以下几方面:长期应用广谱抗菌药物、气管插管以及气管切开、低蛋白血症、长期应用各种激素等。结论:ICU重症患者发生肺部真菌感染后,其主要临床症状、体征多为发热、痰量增多、黏稠、肺部湿啰音;其感染真菌以白色假丝酵母菌居多;长期使用广谱抗菌药物则是引发ICU重症患者肺部真菌感染的主要危险因素。
Objective: To systematically analyze the clinical features of pulmonary fungal infections in intensive care unit (ICU) critically ill patients in order to provide more reference data for clinical treatment. Methods: The clinical data of 145 severe ICU patients with pulmonary fungal infection admitted to our hospital from January 2013 to June 2014 were analyzed retrospectively. The clinical symptoms, signs and fungal species were analyzed statistically. The ICU The systemic risk factors associated with pulmonary fungal infection in patients were systematically analyzed. Results: The main symptoms and signs of 145 ICU critically ill patients were fever, followed by lung wet rales, sputum volume increase, viscous, shortness of breath and so on. 156 strains of fungi were isolated from sputum, pulmonary secretions and blood samples. Candida albicans was the first (52.6%), followed by Candida tropicalis (17.3%), the third was glossy Yeast (11.5%). The risk factors for pulmonary fungal infection in ICU critically ill patients are mostly concentrated in the following aspects: long-term use of broad-spectrum antibiotics, endotracheal intubation and tracheotomy, hypoproteinemia, long-term use of various hormones. Conclusions: The main clinical symptoms and signs of severe ICU patients after pulmonary fungal infection are fever, increase of sputum volume, viscous, lung wet rales; the infection fungi are mostly Candida albicans; long-term use of broad-spectrum antibacterial Drugs are the major risk factors for pulmonary fungal infections in critically ill ICU patients.