摘要
目的探讨非结核分枝杆菌肺病的易患因素、临床特点及治疗与转归。方法对1例慢性阻塞性肺疾病(COPD)长期机械通气合并非结核分枝杆菌肺病的病例诊治过程进行回顾,并结合相关文献进行分析。结果患者通过临床症状、影像学表现、痰涂片诊断为分枝杆菌肺病,经DNA微阵列芯片法行菌种鉴定为龟/脓肿分枝杆菌,给予利福平胶囊、乙胺丁醇片、克拉霉素片口服治疗2月,后因机械通气并发气胸死亡。结论非结核分枝杆菌成为呼吸机相关性肺炎致病菌之一,非结核分枝杆菌肺病多发生在既往有结构性肺病或者细胞免疫功能低下的患者,难以治愈、并发症多,及早诊断是治疗关键。
Objective To investigate the susceptibility, clinical feature, treatment and prognosis of nontuberculous mycobacterial lung disease（NTMLD）. Methods A case of NTMLD in long term mechanical ventilation was studied and analyzed,combining with literature review. Results The patient was diagnosed as NTMLD by clinical symptoms, radio- graphy and bacteria culture of sputum. Nontuberculous mycobacterial （NTM） species was identificl as M. abscessus. INH, RIF and clarithromycin was given in treatment. Two months later, the patient died from pneumothorax. Conclusions NTM is one of pathogenic bacteria in ventilator associated pneumonia. Patients with preexisting structural lung disease and （or） with defects of cell-mediated immunity are at risk of NTMLD. Species identification and susceptibility test are important for the treatment.
出处
《实用老年医学》
CAS
2012年第2期110-113,共4页
Practical Geriatrics
关键词
机械通气
非结核分枝杆菌
感染
mechanical ventilation
nontuberculosis mycobacterium
infection
