摘要
目的对我院1980年1月至1995年5月收治的82例老年人肺部念珠菌感染病例进行分析,探讨其临床特点。方法3%过氧化氢溶液漱口后采取痰标本,连续3次以上痰真菌培养为同一种菌,并结合临床确诊。63例应用氟康唑治疗的患者中,42例口服,第1天300mg,第2天改为150mg,每天1次;另21例患者第1天400mg静滴,第2天改为200mg静滴,每天1次。连续1~2周后改口服150mg,每天1次。疗程3~4周。应用其它抗真菌药物治疗者包括酮康唑14例,两性霉素B1例,5-FC1例。结果63例应用氟康唑治疗患者,病死率9.52%。应用其它抗真菌药物者,治愈9例,死亡7例。氟康唑治疗组12例出现轻度胃肠道反应,其它抗真菌药物组中8例出现轻、中度胃肠道反应。结论老年人肺部念珠菌感染的治疗,除停用抗生素、改善营养状况外。
Objective Clinical features of 82 cases(male 72,female 10,aged 68±5 yrs) of pulmonary candidial infections in the aged admitted to this hospital from January 1980 to May 1995 are analysed.Methods Sputum specimens were collected after rinsing out with 3% hydrogen peroxide solution,pulmonary candidial infections can be diagonesed with three consecutively positive sputum cultures and clinical manifestations.Of 63 patients treated with fluconazole,42 patients were given by oral route with the inital dose of 300mg fluconazole on the first day and then the dose of 150mg fluconazole was administered orally once a day.In the other 21 patients treated with fluconazole,a dose of 400mg was given by intravenous route on the first day and then the dose of 200mg was administered once a day in one to two weeks and after that the dose of 150mg was given orally once a day.The therapy course of fluconazole was three to four weeks.Results The mortality of pulmonary candidial infections in 63 elderly patients treated with fluconazole was 9.52%.In the group of patients treated with other antifungeal agents,including 14 cases treated with ketoconazole,one with amphotericin B and one with 5-flurocytosin,9 cases cured and 7 cases died.12 cases treated with fluconazole suffered from a few side-effects of gastrointestinal tract.In the group treated with other antifungeal agents.8 cases suffered from mild to moderate adverse reaction of gastrointestinal tract.Conclusions The treatment of pulmonary candidial infections in the aged,besides the withdrawal of antimicrobial agents and improvement of nutrition state,antifungeal agents should be early and properly applied.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
1996年第3期156-158,共3页
Chinese Journal of Geriatrics