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目的:分析呼吸内科住院病患肺部真菌感染的临床特点、患病原因及具体治疗方法。方法:从该院2013年02月至2015年10月间呼吸内科住院部收治的肺部真菌感染患者中随机抽取62例,对其基本临床资料、病史资料、易感因素以及治疗过程进行分析和统计。结果:本组62例患者的细菌培养结果显示,发现白假丝酵母菌占51.6%,发现曲霉菌占22.6%。患者中,长期应用广谱抗生素治疗占53.2%,长期应用糖皮质激素治疗占64.5%,放疗、化疗患者占25.8%,使用过免疫抑制剂占9.7%,使用细胞毒药物占6.5%,以及低蛋白血症患者占50.0%。所有患者的基础疾病类型主要包括:慢性肾功能衰竭(24.2%)、阻塞性肺病(48.4%)、肺间质纤维化(27.4%)。本组62例患者治疗的总有效率为93.5%;同时,患者在药物治疗过程中,出现恶心呕吐、腹泻、肝损害、轻度皮疹等不良反应(9.7%),经对症处理后上述不良反应均有显著改善。结论:抗菌药物滥用、基础病和原发病均是呼吸内科住院病患并发肺部真菌感染的原因,在临床工作中要积极治疗基础病,加强用药指导,以预防病情进一步发展。
Objective: To analyze the clinical features, causes and specific treatment of lung fungal infections in respiratory patients in respiratory medicine. Methods: Sixty-two patients were randomly selected from patients with pulmonary fungal infection who were admitted to Department of Respiratory Medicine in the Department of Respiratory Medicine from February 2013 to October 2015 and their basic clinical data, history data, predisposing factors and treatment course were analyzed. statistics. Results: The bacterial culture results of 62 patients in this group showed that Candida albicans accounted for 51.6%, and Aspergillus accounted for 22.6%. Long-term use of broad-spectrum antibiotics accounted for 53.2%, long-term glucocorticoid treatment accounted for 64.5%, radiotherapy and chemotherapy patients accounted for 25.8%, immunosuppressive agents accounted for 9.7%, the use of cytotoxic drugs accounted for 6.5%, and low Patients with leukemia accounted for 50.0%. The basic types of diseases in all patients included chronic renal failure (24.2%), obstructive pulmonary disease (48.4%) and interstitial lung fibrosis (27.4%). The total effective rate of the treatment of 62 patients in this group was 93.5%. At the same time, the patients experienced adverse reactions (9.7%) such as nausea, vomiting, diarrhea, liver damage and mild rash during the drug treatment. After the symptomatic treatment, the above adverse reactions Have significantly improved. Conclusion: Antimicrobial abuse, basic disease and primary disease are the causes of pulmonary fungal infection inpatients with respiratory medicine. In clinical work, we should actively treat the basic diseases and strengthen the guidance of medication to prevent further development of the disease.