本文關(guān)鍵詞： 免疫健全宿主 重癥肺炎 巨細(xì)胞病毒感染　出處：《中國呼吸與危重監(jiān)護(hù)雜志》2015年05期 　論文類型：期刊論文

【摘要】：目的總結(jié)免疫健全者重癥肺炎后活動性巨細(xì)胞病毒感染的臨床特征和診治要點(diǎn)。方法報(bào)告2例于我院呼吸重癥監(jiān)護(hù)病房診治的基礎(chǔ)免疫健全宿主重癥肺炎后巨細(xì)胞病毒活動性感染病例,并結(jié)合文獻(xiàn)資料對該病的危險(xiǎn)因素、臨床特征和診治要點(diǎn)進(jìn)行分析。結(jié)果 2例患者均為老年患者,因"重癥肺炎、Ⅰ型呼吸衰竭"入住我科,經(jīng)有創(chuàng)機(jī)械通氣、廣譜抗生素抗感染、激素抗炎及支持治療后體溫正常,氧合改善,肺部滲出影吸收好轉(zhuǎn),成功脫機(jī)拔管。之后患者氧合進(jìn)一步改善不明顯,且肺部滲出影進(jìn)展,外周血巨細(xì)胞病毒DNA轉(zhuǎn)陽,加用更昔洛韋抗病毒治療后氧合改善,肺部滲出影吸收。結(jié)合文獻(xiàn)資料,在基礎(chǔ)免疫健全者,重癥肺炎后出現(xiàn)活動性巨細(xì)胞病毒感染的危險(xiǎn)因素包括有創(chuàng)機(jī)械通氣、糖皮質(zhì)激素應(yīng)用;臨床特征為氧合惡化、肺部滲出影增多,而普通細(xì)菌、真菌培養(yǎng)無陽性發(fā)現(xiàn);診斷試驗(yàn)包括外周血巨細(xì)胞病毒定量核酸擴(kuò)增試驗(yàn)、巨細(xì)胞病毒pp65抗原檢測和組織病理學(xué)檢查;治療方法推薦纈更昔洛韋片口服或更昔洛韋靜脈滴注,療程至少2周。結(jié)論巨細(xì)胞病毒活動性感染在基礎(chǔ)免疫功能正常的危重癥患者中頻發(fā),對于原發(fā)疾病為重癥肺炎、接受有創(chuàng)機(jī)械通氣及應(yīng)用糖皮質(zhì)激素的患者,需警惕巨細(xì)胞病毒肺炎的發(fā)生,及早診斷并給予相應(yīng)的治療,可改善該類患者的預(yù)后。
[Abstract]:Objective to summarize the immune sound of severe pneumonia after active cytomegalovirus infection and clinical characteristics of diagnosis and treatment. Methods 2 cases of basic immunization in our hospital respiratory ICU treatment of severe pneumonia after perfect host CMV infection cases, and combined with the literature of the disease risk factors, clinical characteristics and treatment analysis the main points. Results 2 patients were elderly patients, because of severe pneumonia, type I respiratory failure "in our department, the invasive mechanical ventilation, broad-spectrum antibiotics, anti-inflammatory and hormone treatment and support normal body temperature, improve oxygenation, lung exudation absorbed, successful extubation after oxygenation. Further improvement is not obvious, and the progress of pulmonary infiltrates, peripheral blood CMV seroconversion to DNA, improve oxygenation combined with ganciclovir after lung exudation absorbed. Combined with the literature ,鍦ㄥ熀紜，

本文編號：1464826