【摘要】 目的探讨慢性阻塞性肺病(COPD)合并慢性呼吸衰竭患者院内肺部真菌感染的危险因素、临床特点及防治对策。方法回顾性分析我院收治30例COPD合并慢性呼吸衰竭继发肺部真菌感染患者的临床资料,并与同期30例无院内真菌感染的COPD合并慢性呼吸衰竭患者对比分析。结果COPD合并慢性呼吸衰竭患者肺部真菌感染除与患者年龄、并发症有关外,还与长期住院、广谱抗生素和糖皮质激素的应用、各种侵入性操作等有密切关系,临床表现无特异性。结论合理使用抗生素和糖皮质激素,减少不必要的侵入性操作,尽快脱机,加强全身营养支持,警惕真菌感染,及早治疗,可以有效防治COPD合并慢性呼吸衰竭患者发生肺部真菌感染,改善其预后。更多还原

【Abstract】 Objective: To discuss the risk factors, clinical characteristics as well as preventive measures of hospital acquired mycotic infection in patients with chronic obstructive pulmonary disease (COPD) complicated with chronic respiratory failure. Methods: Clinical data of 30 COPD patients with chronic respiratory failure infected with hospital acquired mycotic infection were retrospectively analyzed,and compared with 30 COPD patients with chronic respiratory failure without mycotic infection at the same time. Results: There was a close relationship between mycotic infection and age, complications, a long term hospitalization,application of broad-spectrum antibiotics and glucocorticoid hormone,as well as various invasive manipulations. There was no difference with clinical manifestations. Conclusion: Rational utilization of antibiotics and glucocorticoid hormone,reduction of unnecessary invasive manipulations,weaning mechanical ventilation as early as possible, enhance systemic nutritional support, prevent mycotic infection and treat it at early stage shoud be put into practice,these measures might be effective in preventing and treating COPD patients with chronic respiratory failure and it may improve the prognosis.更多还原