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目的对医院急诊重症监护病房(ICU)收治的老年患者发生肺部侵袭性真菌感染的独立高危因素进行Logistic回归分析。方法对该院2012年3月—2014年3月急诊ICU收住的老年患者病历资料进行回顾性分析,其中确诊为肺部侵袭性真菌感染的患者42例,同期住院发生肺部细菌感染但未合并真菌感染患者39例。对潜在的10项指标进行单因素及Logistic多重回归分析,筛选出独立危险因素。结果对10项潜在的危险因素进行单因素分析后,得出抗生素使用时程、抗生素使用类别、使用留置管、肠外营养、应用糖皮质激素、合并糖尿病是肺部侵袭性真菌感染的危险因素。对这6项进行Logistic多因素回归分析后,最后确定这6项是肺部侵袭性真菌感染的独立危险因素。结论在ICU病房,对老年患者要加强病原菌监测,尽可能及早准确地预防侵袭性真菌感染。
Objective To analyze the independent risk factors of pulmonary invasive fungal infection in elderly patients admitted to intensive care unit (ICU) in hospital. Methods A retrospective analysis was performed on the medical records of elderly patients admitted to the emergency ICU from March 2012 to March 2014 in the hospital. Among them, 42 patients were diagnosed as lung invasive fungal infection, 39 patients with fungal infection. Single factor and Logistic multiple regression analysis of the potential 10 indicators, screening out independent risk factors. Results Univariate analysis of 10 potential risk factors led to the conclusion that antibiotic use duration, antibiotic use categories, use of indwelling tubes, parenteral nutrition, glucocorticoid use, and diabetes mellitus were risk factors for pulmonary invasive fungal infections . Logistic multivariate regression analysis of these 6 items confirmed that these 6 items were independent risk factors of pulmonary invasive fungal infection. Conclusion In the ICU ward, pathogen surveillance should be strengthened in elderly patients to prevent invasive fungal infection as soon as possible.