【摘要】 目的 探讨上海中医药大学附属普陀医院呼吸内科病房患者肺部真菌感染发病的易患因素、临床特征和治疗。方法 采用回顾性调查方法对2005年6月～2006年12月收住内科的经微生物检查证实54例继发肺部真菌感染的患者进行分析。结果 在呼吸内科病房中，院内肺部真菌感染发生率为38%，慢性阻塞性肺疾病（518%）是继发院内肺部真菌感染最常见的基础疾病，长期使用广谱抗生素（963%）、低蛋白血症（593%）、长期使用糖皮质激素（333%）及合并糖尿病是主要易患因素。肺部真菌感染的临床表现无特异性，确诊需结合痰培养，组织病理学和临床表现来确定，病原菌以白色假丝酵母菌（611%）为主，氟康唑治疗有效率922%。结论 院内肺部真菌是呼吸系统疾病继发感染的重要病原体，而白色假丝酵母菌是院内肺部真菌感染的主要致病菌，有效的抗真菌治疗外，积极的综合治疗有助于提高真菌感染的治愈率。
【关键词】 肺；院内感染；真菌
Analysis on nosocomial pulmonary fungal infection in respiratory department ward
CAI Zhu-ying，TANG Ji-hong，WANG Lei，et al.Department of Respiratory Diseases，Putuo Hospital，Shanghai University of TCM，Shanghai 200062，China
［Abstract］ Objective To study the susceptible factors，clinical features and treatments of nosocomial pulmonary fungal infection in the ward of respiratory department.Methods The chart files of 54 patients with nosocomial pulmonary fungal infection admitted from June 2005 to December 2006 in the ward of Respiratory Department were reviewed.Results The incidence rate of nosocomial pulmonary fungal infection was 38%.COPD(518%)was the main predisposing disease，and candidiasis(611%) was the most common pathogen. The main susceptible factors associated with nosocomial pulmonary fungal infection are long-term use of broad-spectrum antibiotics(963%)，hypoalbuminemia(593%)，long-term use of adrenocortical steroid(333%)，and diabetes mellitus.There is no specific clinical feature.Fluconazole(922%)is more efficient in the treatment.Conclusion Nosocomial pulmonary fungis are important pathogenin the secondary infection in respiratory disease.The most common pathogen is candida albicans.Combined therapy as well as treating fungus infection are important measures to increase the cure rate of nosocomial pulmonary fungal infection
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