肝衰竭并发侵袭性真菌感染的临床分析

摘要

目的 探讨肝衰竭并发侵袭性真菌感染(invasive fungal infections,IFI)的临床特征.方法 回顾性分析2000年5月～2010年5月笔者医院收治的肝衰竭并发IFI患者的临床资料及相关因素分析.结果 360例肝衰竭中并发IFI129例(35 8%),感染部位以肺部为主(36.4%),其次是消化道(23.3%)、泌尿道(20.2%)、血液(11.6%)及腹腔(8.5%).感染菌种以酵母样菌为主,占72.8%,其次是曲霉菌,占25.3%.抗真菌治疗有效率47.3%,基础疾病治愈好转率31.0%.结论 肝衰竭并发真菌感染预后差,主要的防治措施是积极治疗原发病,合理应用抗生素,减少侵袭性操作,合理选用抗真菌药物.%Objective To evaluate the clinical characteristics of liver failure complicated with invasive fungal infections( IFI) and study the factors affecting the therapeutic efficacy. Methods The case data of patients with liver failure complicated with IFI in our hospital from May 2000 to May 2010 were retrospectively analyzed. Results In 360 patients with liver failure,there were 129 patients complicated with fungas infection( 35. 8％ ) , of which 36. 4％ patients developed IFI in the lungs, 23. 3％ in the digestive tract,20. 2％ in the urinary tract,11. 6％ in the blood and 8. 5％ in the peritoneal cavity respectively. Saccharomycopsis was the most common bacteria, accounting for 72. 8％ and aspergillus for 25. 3％ . Antifungal therapy was effectiye in 47. 3％ of the patients. Underlying disease improved in 31. 0％ of the patients. Conclusion Liver failure complicated with IFI has poor prognosiS. The effective preventive methods are treating underlying diseaBe actively, using antibiotis correctly, reducing invasive opration and using antifungal agents correctly.