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目的:分析恶性血液病患者并发真菌败血症的临床特征,以进一步探讨其相关危险因素和早期诊治措施。方法:对我院血液内科诊治的18例恶性血液病患者并发真菌败血症的临床资料进行回顾性分析。结果:18例患者均出现发热,发热期间均使用广谱抗生素治疗,7例患者行预防性或经验性抗真菌治疗。其中16例伴有粒细胞缺乏症。血培养结果主要为热带念珠菌(11例)。共7例(38.9%)死亡,11例病情好转。共7例发生休克,其中5例死亡。结论:恶性血液病患者并发真菌败血症早期诊断困难,预后不良,易发生感染性休克,病死率较高。早期预防及早期诊断,积极正规反复多次行真菌血培养,及时合理抗真菌药治疗和积极抗休克治疗,是降低真菌性败血症病死率的重要措施。
Objective: To analyze the clinical characteristics of patients with hematological malignancies complicated with fungal sepsis to further explore its related risk factors and early diagnosis and treatment measures. Methods: The clinical data of 18 patients with hematological malignancies complicated by fungal sepsis were retrospectively analyzed. RESULTS: All 18 patients experienced fever and were treated with broad-spectrum antibiotics during fever and 7 patients were treated with prophylactic or empirical antifungal therapy. 16 cases with agranulocytosis. Blood culture results mainly for Candida tropicalis (11 cases). A total of 7 patients (38.9%) died, 11 patients improved. A total of 7 cases of shock occurred, of which 5 died. Conclusions: The early diagnosis of fungal septicemia complicated with malignant hematological diseases is difficult, the prognosis is poor, septic shock is easy to occur, and the mortality rate is high. Early prevention and early diagnosis, positive and repeated repeated fungal blood culture, timely and reasonable anti-fungal drug treatment and active anti-shock therapy is to reduce fungal sepsis mortality is an important measure.