內科醫學畢業論文參考

　　探討上海中醫藥大學附屬普陀醫院呼吸內科病房患者肺部真菌感染發病的易患因素、臨床特征和治療。方法 采用回顧性調查方法對xx年6月～xx年12月收住內科的經微生物檢查證實54例繼發肺部真菌感染的患者進行分析。結果 在呼吸內科病房中，院內肺部真菌感染發生率為3��8%，

　　慢性阻塞性肺疾病(51��8%)是繼發院內肺部真菌感染最常見的基礎疾病，長期使用廣譜抗生素(96��3%)、低蛋白血癥(59��3%)、長期使用糖皮質激素(33��3%)及合并糖尿病是主要易患因素。肺部真菌感染的臨床表現無特異性，確診需結合痰培養，組織病理學和臨床表現來確定，病原菌以白色假絲酵母菌(61��1%)為主，氟康唑治療有效率92��2%。結論 院內肺部真菌是呼吸系統疾病繼發感染的重要病原體，而白色假絲酵母菌是院內肺部真菌感染的主要致病菌，有效的抗真菌治療外，積極的綜合治療有助于提高真菌感染的治愈率。

　　analysis on nosocomial pulmonary fungal infection in respiratory department ward

　　cai zhu-ying，tang ji-hong，wang lei，et al.department of respiratory diseases，putuo hospital，shanghai university of tcm，shanghai xx62，china

　　[abstract] objective to study the susceptible factors，clinical features and treatments of nosocomial pulmonary fungal infection in the ward of respiratory department.methods the chart files of 54 patients with nosocomial pulmonary fungal infection admitted from june to december in the ward of respiratory department were reviewed.results the incidence rate of nosocomial pulmonary fungal infection was 3��8%.copd(51��8%)was the main predisposing disease，and candidiasis(61��1%) was the most common pathogen. the main susceptible factors associated with nosocomial pulmonary fungal infection are long-term use of broad-spectrum antibiotics(96��3%)，hypoalbuminemia(59��3%)，long-term use of adrenocortical steroid(33��3%)，and diabetes mellitus.there is no specific clinical feature.fluconazole(92��2%)is more efficient in the treatment.conclusion nosocomial pulmonary fungis are important pathogenin the secondary infection in respiratory disease.the most common pathogen is candida bined therapy as well as treating fungus infection are important measures to increase the cure rate of nosocomial pulmonary fungal infection

　　[key words] lung;nosocomial infection;fungal

　　真菌屬于條件致病菌，只有在機體免疫功能低下或菌群失調時才引起感染。近年來，隨著廣譜抗生素、糖皮質激素、免疫抑制劑的長期應用，已有一些慢性病生存時間延長，各種導管介入性治療和器官移植治療的深入開展，系統性真菌感染的發病率不斷增加