本文關(guān)鍵詞：醫(yī)院肺部真菌感染臨床病例薈萃分析，由筆耕文化傳播整理發(fā)布。

網(wǎng)友你是我的全部近日為您收集整理了關(guān)于醫(yī)院肺部真菌感染臨床病例薈萃分析的文檔，希望對您的工作和學(xué)習(xí)有所幫助。以下是文檔介紹：南昌大學(xué)醫(yī)學(xué)院碩士學(xué)位論文醫(yī)院肺部真菌感染臨床病例薈萃分析姓名:陳剛申請學(xué)位級別:碩士專業(yè):內(nèi)科學(xué)指導(dǎo)教師:顏春松20070515摘要摘要目的了解國內(nèi)近十年來醫(yī)院肺部真菌感染(PFIH)診治等方面的研究現(xiàn)狀,以提高臨床診治水平。方法檢索我國1996---,2006年核心期刊發(fā)表的PFIH臨床病例分析結(jié)果進行匯總、歸納和統(tǒng)計分析。結(jié)果共檢索到文獻(xiàn)60篇,其中19篇(病例總數(shù)1201例)進入薈萃分析。PFIH的發(fā)生率約為0.7%,PFIH占同期下呼吸道感染的5.1%,ICU中PFIH發(fā)生率為7.8%;易感因素分析顯示長期使用抗生素、長期使用糖皮質(zhì)激素、住院時間長(>3周)、接受放、化療、呼吸道侵入性操作等與PFIH有關(guān),有顯著統(tǒng)計學(xué)意義(與對照組比較P<0.01);基礎(chǔ)疾病分析顯示呼吸系統(tǒng)疾病占65.26%,其中又以COPD占首位:ICU病例中,顱腦外傷(含術(shù)后)占55.69%;臨床表現(xiàn)分析顯示無特異性;國內(nèi)的PFIH診斷標(biāo)準(zhǔn)大多以衛(wèi)生部2001年頒布的醫(yī)院感染診斷標(biāo)準(zhǔn)(試行)為基礎(chǔ):病原學(xué)分析顯示念珠菌占84.78%,其中又以白色念珠菌占首位;病原學(xué)診斷方法顯示我國仍主要依靠痰液培養(yǎng),而采取肺組織學(xué)檢查診斷者極少;治療以***康唑為主;PFIH死亡率為11.7%,ICU中PFIH患者死亡率高達(dá)36.7%。結(jié)論PFIH其臨床表現(xiàn)特異性少,病死率高,基礎(chǔ)疾病以呼吸系統(tǒng)疾病為主,易感因素包括長期使用抗生素、長期使用糖皮質(zhì)激素、長時間住院、接受放、化療、呼吸道侵入性操作等;國內(nèi)的病原學(xué)多以痰培養(yǎng)作為診斷依據(jù),診斷標(biāo)準(zhǔn)不太一致,與國外以及國內(nèi)頒布的最新診治指南存在一定的差距,有待于進一步改進和規(guī)范。關(guān)鍵詞肺;真菌感染;薈萃分析IIAbstractABSTRACTObjective Obtainingan objective and integratedunderstanding of Chinesediagnoseand treatment status with pulmonary fungal infections in hospital(PFIH)inthis ten years,to guide clinical practice.MethodsUse Meta-analysis to conclude clinical articles about PFIH retrievallingin the period from 1 996 to 2006.Results60 articles were identified,1 9articles(total cases1 201)were selected forMeta-analysis.The general incidence ofPFIH iS 0.7%.It accounts5.1%inlowerrespiratory infection in hospitalized patientswith the same period,and accounts7.8%in ICU patients.Data for me predisposingfactoranalysis demonstrates use of broadspectrum antibioticsand/or steroids overalong period,length of stayover3 weeks,experiencing radiotherapyor chemotherapy,invasivemanipulation with respiratorytract to be statistical significance(vs control group,P<O.01).Data for the predisposingdisease analysis demonstrates that disease of respiratory ounts 65.26%oftotal cases,among them,COPD is in the first place;In ICU cases,craniocerebraltrauma accounts 55.69%.The clinicalmanifestation of PFIHis not specific.Data forfungi separationanalysis demonstrates Candida was ranked thefirstpathogen(84.78%),among them,Candida albicans is the main pathogen.Aetiologydiagnosticmethod demonstrates it dependson sputum culture in major,and adopts histologytodiagnose is few.Data for mortalityanalysis demonstrates the general mortality ofPFIH is about 11.7%.but in ICU patients it iS to 36.7%.ConclusionsThe clinical features of PFIH iS non—specific,the morbidity isrising.Disease of respiratory system is the main predisposing disease.The predisposingfactor includeuse of broad spectrumantibioticsand/or steroids overalong period,hospitalizationoveralong period,experiencing radiotherapyor chemotherapy,invasive manipulationwith respiratory tract.The aetiologydiagnosis mainly dependson sputum culture.Thediagnostic criteria of domestic isdiscordant,and there iS pare with latest diagnosisand treatment guide of domestic and overseas,it iS time to improve and standard step by step asSOOIl as possible.KeyWordsLung;Fungalinfection;Meta-analysis.III縮略詞縮略詞1、PFIH(Pulmonary Fungal Infections inHospital):醫(yī)院肺部真菌感染2、IFI(Invasive Funga

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  本文關(guān)鍵詞：醫(yī)院肺部真菌感染臨床病例薈萃分析，由筆耕文化傳播整理發(fā)布。