论文部分内容阅读
目的观察泊沙康唑预防儿童急性白血病及急性重型再生障碍性贫血治疗中肺部侵袭性真菌感染(IFI)的效果及安全性;寻求安全高效的真菌预防药物,提高儿童急性白血病及急性重型再生障碍性贫血治愈率。方法回顾性分析2014年12月-2015年9月医院接受泊沙康唑预防肺部真菌治疗的20例患儿临床资料,与同期接受氟康唑预防肺部真菌治疗的25例患儿进行对比观察。结果采用泊沙康唑预防肺部侵袭性真菌感染的效果明显优于氟康唑组,差异有统计学意义(P<0.05);氟康唑组中既往发生过肺部IFI的患儿,继续选择氟康唑预防治疗的患儿6例,3例患儿在粒缺期再次出现肺部真菌感染复燃,1例患儿因肺部严重曲霉菌感染放弃治疗死亡,2例患儿未再发生肺部IFI;预防有效率仅为33.3%;泊沙康唑组中11例患儿既往发生过肺部IFI,改用泊沙康唑预防肺部真菌感染后,均未再次发生肺部IFI,预防有效率为100%,两组患儿预防有效率差异有统计学意义(P<0.05),两组均无明显不良反应发生。结论泊沙康唑能更有效预防高危血液恶性病患儿的肺部侵袭性真菌感染,临床安全性与氟康唑相当,具有较高的安全性。
Objective To observe the efficacy and safety of posaconazole in the prevention of pulmonary invasive fungal infection (IFI) in the treatment of acute leukemia and acute severe aplastic anemia in children. To find a safe and effective fungal preventive drug to improve the acute leukemia and acute heavy-type regeneration in children Obstructive anemia cure rate. Methods The clinical data of 20 children who received posaconazole for prevention of pulmonary fungal in our hospital from December 2014 to September 2015 were retrospectively analyzed and compared with 25 children who were treated with fluconazole for prevention of pulmonary fungi in the same period Observed. Results The efficacy of posaconazole in preventing lung invasive fungal infection was significantly better than that in the fluconazole group (P <0.05). The incidence of pulmonary IFI in the fluconazole group continued Six children with fluconazole prophylaxis were treated. Three patients relapsed after the fungal infection of the lung in the absence of granulomatosis. One patient died of severe pulmonary fungal infection and two died. The occurrence of pulmonary IFI; the effective rate of prevention was only 33.3%. In the posaconazole group, 11 patients had previous pulmonary IFI. After switching to posaconazole to prevent pulmonary fungal infection, no pulmonary IFI occurred again , And the effective rate of prevention was 100%. The effective rate of prevention in both groups was statistically significant (P <0.05), and no adverse reactions occurred in both groups. Conclusion Posaconazole is more effective in preventing lung invasive fungal infection in children with high-risk hematological malignancies, and its safety is comparable to that of fluconazole.