【作者】 丁士芳； 孙恩华； 陈晓梅； 王可富； 翟茜； 李琛；

【Author】 Ding Shi-Fang, Sun En-Hua,Chen Xiao-Mei Department of Intensive Care Unit. Qilu Hospital ShanDong University, Jinan, 250012

【机构】 山东大学齐鲁医院；

【摘要】 目的初步探讨中心静脉导管相关性真菌败血症的临床特点、发病机制与防治措施。方法对31例中心静脉导管相关性真菌败血症患者的基础疾病、易患因素、导管真菌培养结果、治疗措施等进行临床分析。结果所有患者均有2个或以上易患因素,CVC留置时间≥7d。分离得到34株真菌, 以非白色念珠菌(24株／34株)为主。3例患者拔管2-3d后体温降至正常,余患者给予氟康唑治疗10-14 天,12例死亡。结论中心静脉导管相关性真菌败血症的发病机制以肠源性菌群失调、真菌移位为主, 及时恢复胃肠粘膜功能是有效的防治措施。更多还原

【Abstract】 Objective To study the clinical characteristics, pathogenesis, antifugal therapy and prophylaxis for catheter-related candidemia. Methods Retrospective study of underlie disease, predispose factors, distribution of pathogens, treatment measures of 31 patients with catheter related candidemia. Results Each patient had two or more predispose factors and the retention of catheter≥7days, 34 fungi were isolated and Non-C. albicans species (24strains/34strains)were major pathogens, all patients were removed catheter . only 3 patients were not received antifungal treatment and recorery, 28 patients received fluconazole therapy, 12 patients died. Conclusion The pathogenesis of catheter-related candidemia was fungi translocation from gastrointestinal tract to blood, and removed catheter is effective measures, however, To recovery gut function is the foundation of prophylaxis for catheter-related candidemia.更多还原