支气管扩张继发肺部真菌感染的危险因素分析及护理对策
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摘要
目的探讨支气管扩张继发肺部真菌感染的危险因素及护理对策。方法选择衢州市人民医院2016年3月—2018年4月间收治的74例支气管扩张继发肺部真菌感染的患者为真菌感染组,118例支气管扩张非合并肺部真菌感染的患者为非真菌感染组。对2组年龄、性别、合并肺部基础疾病、住院时间长、合并糖尿病、低蛋白血症、呼吸衰竭、抗菌药物使用时间、长期使用糖皮质激素等情况进行统计,并采用单因素和多因素分析确定支气管扩张合并肺部真菌感染患者的危险因素。结果单因素结果显示:年龄、合并肺部基础疾病、住院时间长、合并糖尿病、低蛋白血症、抗菌药物使用时间、呼吸衰竭、长期使用糖皮质激素是支气管扩张患者发生肺部真菌感染的单因素危险因素,多因素Logistic回归分析结果显示:年龄、合并肺部基础疾病、住院时间长、合并糖尿病、低蛋白血症、抗菌药物使用时间、呼吸衰竭、长期使用糖皮质激素是支气管扩张患者发生肺部真菌感染的独立危险因素。结论年龄、合并肺部基础疾病、住院时间长、合并糖尿病、低蛋白血症、抗菌药物使用时间、呼吸衰竭、长期使用糖皮质激素是支气管扩张合并肺部真菌感染患者的危险因素,临床中要重视危险因素,做好治疗和护理,预防真菌感染的发生。
Objective To investigate the risk factors and nursing strategies of bronchiectasis secondary pulmonary fungal infection. Methods A total of 74 patients with bronchodilator secondary pulmonary fungal infection in our hospital from March 2016 to April 2018 were selected as fungal infection group,and 118 patients with bronchiectasis non-common pulmonary fungal infection were selected as non-fungal infections group. The age,sex,combined basic lung disease,hospital time,diabetes,hypoproteinemia,respiratory failure,antibiotic using time,long-term use of glucocorticoids of two groups were accounted,and univariate and logistic regression analysis were used to investigate the risk factors. Results Univariate results showed that age,combined pulmonary basic disease,hospital time,diabetes,hypoproteinemia,antibiotic using time,respiratory failure,long-term use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection,and logistic regression analysis showed that age,combined pulmonary basic disease,hospital time,diabetes,hypoproteinemia,antibiotic using time,respiratory failure,long-term use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection. Conclusion Age,combined pulmonary basic disease,hospital time,diabetes,hypoproteinemia,antibiotic using time,respiratory failure,longterm use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection. So risk factors should receive attention,and treatment and nursing should be carried out to prevent fungal infections.
Objective To investigate the risk factors and nursing strategies of bronchiectasis secondary pulmonary fungal infection. Methods A total of 74 patients with bronchodilator secondary pulmonary fungal infection in our hospital from March 2016 to April 2018 were selected as fungal infection group,and 118 patients with bronchiectasis non-common pulmonary fungal infection were selected as non-fungal infections group. The age,sex,combined basic lung disease,hospital time,diabetes,hypoproteinemia,respiratory failure,antibiotic using time,long-term use of glucocorticoids of two groups were accounted,and univariate and logistic regression analysis were used to investigate the risk factors. Results Univariate results showed that age,combined pulmonary basic disease,hospital time,diabetes,hypoproteinemia,antibiotic using time,respiratory failure,long-term use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection,and logistic regression analysis showed that age,combined pulmonary basic disease,hospital time,diabetes,hypoproteinemia,antibiotic using time,respiratory failure,long-term use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection. Conclusion Age,combined pulmonary basic disease,hospital time,diabetes,hypoproteinemia,antibiotic using time,respiratory failure,longterm use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection. So risk factors should receive attention,and treatment and nursing should be carried out to prevent fungal infections.
引文
[1]李晓云,刘双.支气管扩张病因的研究进展[J].心肺血管病杂志,2014,33(1):124-126.
[2]焦瑞,刘双.支气管扩张症急性加重期研究进展[J].心肺血管病杂志,2015,34(3):236-238.
[3] WANG J Y,WANG D Q,QI X L,et al. Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea[J]. Int J Ophthalmol,2018,11(2):223.
[4]孙灿.支气管扩张合并支气管哮喘的诊治分析[J].中国继续医学教育,2016,15(4):152-158.
[5]中国侵袭性肺部真菌感染工作组.侵袭性肺部真菌感染的诊断标准与治疗原则(草案)[J].中国实用内科杂志,2006,26(21):1748-1751.
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[8]田欣伦,吴翔,徐凯峰,等.成人支气管扩张患者的病因及临床特点分析[J].中国呼吸与危重监护杂志,2013,12(6):576-580.
[9]郑凯宇,唐开华,李耀华,等.支气管扩张并发真菌性肺部感染相关因素分析[J].临床医学,2014,34(2):6-7.
[10]史燕,方英,李云娜,等.慢性阻塞性肺疾病合并肺部真菌感染的危险因素分析及护理对策[J].中华全科医学,2018,16(2):309-312.
[11] AYARI A,SMADHI H,HAMED W B,et al. Le traitement chirurgical des bronchectasies:quelles perspectives?[J]. Rev Mal Respir,2015,32(5):A179-A179.
[12]李红英.对合并肺部感染的慢性支气管炎患者进行个性化护理的效果分析[J].中华全科医学,2016,14(22):173-174.
[13]黄富,梁永祥,罗玥月.呼吸内科病房院内肺部真菌感染的临床分析[J].医学综述,2014,20(24):4572-4574.
[14] SCHULZE B,PIEHLER D,ESCHKE M,et al. Therapeutic expansion of CD4+Fox P3+regulatory T cells limits allergic airway inflammation during pulmonary fungal infection[J]. Pathog Dis,2016,74(4):ftw020.
[15]潘秀琴.老年晚期肺癌化疗后下呼吸道真菌感染的护理观察[J].中华肿瘤防治杂志,2016,23(S1):305-306.
[16]郭金云.呼吸机相关性肺部真菌感染的危险因素研究[J].中国医疗器械信息,2018,24(11):40-41.
[17]宋梅娟,王英.一例两性霉素B雾化吸入治疗COPD患者合并口腔真菌感染的护理[J].实用临床护理学电子杂志,2018(23):143,159.
[18]郑纪玉.老年呼吸系统内科相关感染因素[J].中西医结合心血管病电子杂志,2018,6(9):185-186.
[19]吴会平.老年慢性支气管炎合并真菌感染患者的护理[J].中西医结合心血管病电子杂志,2018,6(4):163.
[20]段隆喜,石友斌,吴晓英,等. 60例重型颅脑损伤患者气管切开术后肺部感染的原因分析及其对策[J].抗感染药学,2017,14(1):70-72.
[21]梁倩,黄彩云,梁艳珍. ICU重症肺炎合并真菌感染的临床观察与护理[J].护理实践与研究,2017,14(1):35-36.
[22]黄晨.重症哮喘患者口腔真菌感染危险因素及护理经验[J].中华实验和临床感染病杂志(电子版),2016,10(6):739-742.
[23]潘秀琴.老年晚期肺癌化疗后下呼吸道真菌感染的护理观察[J].中华肿瘤防治杂志,2016,23(S1):305-306.
[2]焦瑞,刘双.支气管扩张症急性加重期研究进展[J].心肺血管病杂志,2015,34(3):236-238.
[3] WANG J Y,WANG D Q,QI X L,et al. Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea[J]. Int J Ophthalmol,2018,11(2):223.
[4]孙灿.支气管扩张合并支气管哮喘的诊治分析[J].中国继续医学教育,2016,15(4):152-158.
[5]中国侵袭性肺部真菌感染工作组.侵袭性肺部真菌感染的诊断标准与治疗原则(草案)[J].中国实用内科杂志,2006,26(21):1748-1751.
[6] MURRIS-ESPIN M. Pyocyanique et bronchectasies mucoviscidosiques et non mucoviscidosiques de l’adulte:de la colonisationàl’infection[J]. Rev Mal Respir Actualités,2013,5(1):47-53.
[7]林庆育,林群英,王善钻.支气管扩张继发肺部真菌感染的危险因素分析[J].中国医药指南,2016,14(19):54-55.
[8]田欣伦,吴翔,徐凯峰,等.成人支气管扩张患者的病因及临床特点分析[J].中国呼吸与危重监护杂志,2013,12(6):576-580.
[9]郑凯宇,唐开华,李耀华,等.支气管扩张并发真菌性肺部感染相关因素分析[J].临床医学,2014,34(2):6-7.
[10]史燕,方英,李云娜,等.慢性阻塞性肺疾病合并肺部真菌感染的危险因素分析及护理对策[J].中华全科医学,2018,16(2):309-312.
[11] AYARI A,SMADHI H,HAMED W B,et al. Le traitement chirurgical des bronchectasies:quelles perspectives?[J]. Rev Mal Respir,2015,32(5):A179-A179.
[12]李红英.对合并肺部感染的慢性支气管炎患者进行个性化护理的效果分析[J].中华全科医学,2016,14(22):173-174.
[13]黄富,梁永祥,罗玥月.呼吸内科病房院内肺部真菌感染的临床分析[J].医学综述,2014,20(24):4572-4574.
[14] SCHULZE B,PIEHLER D,ESCHKE M,et al. Therapeutic expansion of CD4+Fox P3+regulatory T cells limits allergic airway inflammation during pulmonary fungal infection[J]. Pathog Dis,2016,74(4):ftw020.
[15]潘秀琴.老年晚期肺癌化疗后下呼吸道真菌感染的护理观察[J].中华肿瘤防治杂志,2016,23(S1):305-306.
[16]郭金云.呼吸机相关性肺部真菌感染的危险因素研究[J].中国医疗器械信息,2018,24(11):40-41.
[17]宋梅娟,王英.一例两性霉素B雾化吸入治疗COPD患者合并口腔真菌感染的护理[J].实用临床护理学电子杂志,2018(23):143,159.
[18]郑纪玉.老年呼吸系统内科相关感染因素[J].中西医结合心血管病电子杂志,2018,6(9):185-186.
[19]吴会平.老年慢性支气管炎合并真菌感染患者的护理[J].中西医结合心血管病电子杂志,2018,6(4):163.
[20]段隆喜,石友斌,吴晓英,等. 60例重型颅脑损伤患者气管切开术后肺部感染的原因分析及其对策[J].抗感染药学,2017,14(1):70-72.
[21]梁倩,黄彩云,梁艳珍. ICU重症肺炎合并真菌感染的临床观察与护理[J].护理实践与研究,2017,14(1):35-36.
[22]黄晨.重症哮喘患者口腔真菌感染危险因素及护理经验[J].中华实验和临床感染病杂志(电子版),2016,10(6):739-742.
[23]潘秀琴.老年晚期肺癌化疗后下呼吸道真菌感染的护理观察[J].中华肿瘤防治杂志,2016,23(S1):305-306.