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目的观察与分析重症监护病房中心静脉置管相关性血流真菌感染的临床特点及影响预后的因素。方法选取我院2013年3月至2014年3月收治50例中心静脉置管相关性血流真菌感染患者为研究对象,分析其临床特点以及生化指标与预后的相关性。结果 50例CVC—RBFI患者的基础疾病有:肿瘤、神经系统疾病、腹部疾病、肺部疾病,分别占34%、28%、20%、18%;诱发CVC—RBFI的因素包括:使用广谱抗菌药物时间超过5天、使用两种以上的广谱抗菌药物、中心静脉导管留置时间超过5天;CVC—RBFI患者中检出白色假丝酵母菌有19例,检出近平滑假丝酵母菌有16例,检出光滑假丝酵母菌有10例,检出热带滑假丝酵母菌有5例。结论 CVC—RBFI的主要病原菌为非白色假丝酵母,且病死率加高、加强对诱发因素和敏感性真菌药物的监测,能有效改善导管相关性血流真菌感染的预后。
Objective To observe and analyze the clinical features of blood flow fungus infection associated with central venous catheterization in ICU and the factors influencing the prognosis. Methods From March 2013 to March 2014 in our hospital, 50 patients with central venous catheter-related bloodstream fungal infection were enrolled in this study. The clinical features, biochemical markers and prognosis were analyzed. RESULTS: The prevalence of CVC-RBFI in 50 patients with CVC-RBFI was 34%, 28%, 20% and 18% respectively for underlying diseases of cancer, nervous system, abdominal disease and lung disease. The factors that induced CVC-RBFI included the following: Antibacterial drugs for more than 5 days, the use of more than two kinds of broad-spectrum antibiotics, central venous catheter indwelling more than 5 days; CVC-RBFI patients were detected in Candida albicans in 19 cases, the detection of Candida parapsilosis In 16 cases, 10 cases of Candida glabrata were detected and 5 cases of Candida tropicalis were detected. Conclusions The main pathogen of CVC-RBFI is non-Candida albicans, and its mortality is higher. The monitoring of predisposing factors and sensitive fungi and drugs can effectively improve the prognosis of catheter-associated FFA.