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目的探讨机械通气患者真菌性呼吸机相关性肺炎(FVAP)的易患因素和病原学特点。方法 42例呼吸机相关性肺炎(VAP)患者分为FVAP组15例和非真菌性呼吸机相关性肺炎(NFVAP)组27例,比较两组真菌感染的易患因素及FVAP组病原菌的分布特点。结果 FVAP组全身应用激素、联合应用抗菌药物和机械通气时间较长(>7d)的比例显著大于NFVAP组(P<0.05);FVAP组痰标本共培养出真菌15例,其中假丝酵母菌属12株(80%),烟曲霉菌3株(20.0%)。结论为避免FVAP的发生,应尽可能缩短机械通气时间并严格掌握全身应用激素适应证和剂量,明确感染真菌菌属及其敏感药物。
Objective To investigate the predisposing and etiological characteristics of fungal ventilator-associated pneumonia (FVAP) in patients with mechanical ventilation. Methods Twenty-two patients with ventilator-associated pneumonia (VAP) were divided into FVAP group (n = 15) and non-Fungal ventilator-associated pneumonia group (n = 27). The susceptible factors of fungal infection and the distribution of pathogens in FVAP group were compared . Results The ratio of systemic hormones, antimicrobial agents and mechanical ventilation in the FVAP group was significantly longer than that in the NFVAP group (> 7 days) (P <0.05). In the FVAP group, 15 cases of fungi were co-cultured with Candida albicans 12 strains (80%), 3 strains of Aspergillus fumigatus (20.0%). Conclusion To avoid the occurrence of FVAP, mechanical ventilation should be shortened as much as possible and strictly controlled by systemic indications and doses of hormones, fungi and their sensitive drugs clearly infected.