【摘要】：目的對(duì)諾卡菌培養(yǎng)陽(yáng)性病例的臨床特點(diǎn)進(jìn)行分析,提高對(duì)諾卡菌病的認(rèn)識(shí)。方法回顧性分析寧夏醫(yī)科大學(xué)總醫(yī)院2012年5月至2016年5月住院患者標(biāo)本培養(yǎng)為諾卡菌陽(yáng)性的患者的臨床資料。結(jié)果20例諾卡菌培養(yǎng)陽(yáng)性病例中3例考慮污染所致,其余17例為不同部位感染,其中2例為播散性感染,12例為肺部感染,2例為軟組織感染,1例為透析相關(guān)性腹膜炎;17例均合并基礎(chǔ)疾病,其中7例因基礎(chǔ)病使用糖皮質(zhì)激素或免疫抑制劑。17例中2例死亡,余15例經(jīng)復(fù)方新諾明、米諾環(huán)素、阿米卡星、美羅培南、三代頭孢等治療后病情好轉(zhuǎn)出院;隨訪9例痊愈,其中5例口服復(fù)方新諾明片聯(lián)合或不聯(lián)合米諾環(huán)素片治療6個(gè)月到15個(gè)月不等,4例病情反復(fù),其中3例合并支氣管擴(kuò)張,2例失訪。結(jié)論諾卡菌可引起全身各部位感染,以肺為常見(jiàn)。有基礎(chǔ)疾病者易發(fā)生諾卡菌感染,尤其使用糖皮質(zhì)激素及免疫抑制劑患者。諾卡菌病無(wú)特異臨床表現(xiàn)。治療一線藥物為磺胺類(lèi),氨基糖苷類(lèi)、三代頭孢等亦為可選藥物。諾卡菌病的預(yù)后感染部位、有否基礎(chǔ)疾病、治療及時(shí)否等因素有關(guān)。
[Abstract]:Objective to analyze the clinical characteristics of positive cases of Nocardial bacilli culture and to improve the understanding of Nocardiosis. Methods the clinical data of Nocardial bacillus positive specimens cultured from May 2012 to May 2016 in General Hospital of Ningxia Medical University were analyzed retrospectively. Results among the 20 cases of positive culture of Nocardial bacillus, 3 cases were caused by contamination, the other 17 cases were infected by different sites, 2 cases were disseminated infection, 12 cases were pulmonary infection, 2 cases were soft tissue infection, and 1 case was dialysation-associated peritonitis. Among the 17 cases, 7 cases were treated with glucocorticoid or immunosuppressant, 2 cases died, the remaining 15 cases were treated with compound sulfamine, minocycline, amikacin, meropenem. After the third generation of cephalosporal treatment, the condition was improved and discharged. 9 cases were followed up. Among them, 5 cases were treated with or without minocycline compound tablets for 6 months to 15 months, 4 cases were repeated, 3 cases were complicated with bronchiectasis and 2 cases lost their visits. Conclusion Nocardial bacillus can cause infection in all parts of the body, and the lung is the most common infection. People with underlying diseases are prone to Nocardial infections, especially with glucocorticoids and immunosuppressants. Nocariasis has no specific clinical manifestations. The first-line drugs are sulfanilamide, aminoglycosides and third generation cephalosporins. The prognosis of nocariasis infection site, whether the underlying disease, timely treatment and other factors related to.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R519.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉逸凡;張寧;唐妮娜;王艷;邵樂(lè)平;孫建平;;中樞神經(jīng)系統(tǒng)奴卡菌感染診治分析附一例鼻疽奴卡菌腦膿腫[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2016年33期

2 李云;劉立翠;馮偉;王丕明;王月玲;;腹水穿刺液皮疽諾卡菌的鑒定(附1例報(bào)告)[J];齊魯醫(yī)學(xué)雜志;2016年04期

3 郭錦洲;許書(shū)添;姜玲;高二志;劉志紅;李世軍;;腎病綜合征患者合并播散性奴卡菌感染的臨床特征[J];腎臟病與透析腎移植雜志;2016年03期

4 劉濤華;王顏顏;牟麗麗;呂倩;陳燕;張榮慶;康穎倩;;11株臨床諾卡菌16S rRNA及藥敏分析[J];貴陽(yáng)醫(yī)學(xué)院學(xué)報(bào);2016年03期

5 賈練;劉丹;梁宗安;韓瑤;王茂筠;黃維維;;肺奴卡菌病的臨床特征與診治分析[J];西部醫(yī)學(xué);2016年01期

6 李路茜;張媛媛;劉海燦;譚曉羅;李振軍;樓永良;;16S rDNA序列在諾卡菌菌種鑒定中的價(jià)值研究[J];中國(guó)人獸共患病學(xué)報(bào);2015年11期

7 戴望春;曾慶思;周嘉璇;劉琴;黃曉燕;王壽揚(yáng);陳源;;肺諾卡菌病胸部CT特征[J];中國(guó)醫(yī)學(xué)影像技術(shù);2015年07期

8 朱濤輝;尤偉波;任建敏;黃金偉;李慧敏;丁卉;;誤診為肺結(jié)核的肺星型諾卡菌病1例[J];浙江實(shí)用醫(yī)學(xué);2015年01期

9 謝yN;侯雪新;徐帥;張景山;劉愛(ài)忠;李振軍;;53例諾卡菌感染病例臨床特征分析[J];疾病監(jiān)測(cè);2015年01期

10 茆海豐;陳東科;;自眼分泌物分離膿液諾卡菌1例[J];臨床檢驗(yàn)雜志;2014年08期

相關(guān)碩士學(xué)位論文 前2條

1 孫渭歌;諾卡菌多重PCR及Real-time PCR檢測(cè)方法的建立[D];鄭州大學(xué);2014年

2 俞慧麗;肺奴卡菌病4例并文獻(xiàn)復(fù)習(xí)分析肺部影像學(xué)改變[D];浙江大學(xué);2011年

，

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