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我科自１９９４年来共收治１７例合并霉菌感染的患者，现将临床表现、诊治体会报道如下。临床资料１７例中男７例，女１０例。年龄３２～７１岁，平均４８岁。霉菌感染发生在外科手术后１５例，未手术者２例。外科疾病为急性炎症６例，消化道肿瘤５例，肝硬化２例，肠瘘１例，化疗３例。其中５例合并糖尿病。病原菌主要是念珠菌，特别是白色念珠菌最常见（１２例），酵母菌２例，其余３例找到霉菌菌丝、未定菌种。本组霉菌系从口腔分泌物、大小便、痰液、创口分泌物、植入物血液等标本中经涂片或霉菌培养证实。１项标本找到１０例，２项标本６例，３项标本证实１例。本组共作涂片找霉菌６７次，阳性２６次，阳性率３８％。霉菌培养２５次，阳性８次，阳性率３２％。本组病例除有原外科疾病的症状外，尚有霉菌感染时的一些特有症状。精神症状：精神萎靡、嗜睡、神志淡漠、精神恍惚。消化道症状：口腔粘膜真菌斑、舌炎、食道炎、吞咽困难。呼吸道症状：呼吸困难、干咳、高热、胸膜炎性疼痛。体温：病人有３８℃～４０℃发热，大多为弛张热，周围血象：白细胞常升高至２０×１０９／Ｌ居多。治疗方法在全身支持治疗的同时，采取１、终止促成霉菌感染的治疗。在原疾病治疗允许的情况下，停用或推迟用抗生素?
Our department since 1994 treated a total of 17 cases of patients with fungal infection, now the clinical manifestations, diagnosis and treatment experience are reported below. 17 cases of clinical data in 7 males and 10 females. Age 32 ~ 71 years old, average 48 years old. Mold infection occurred in 15 cases after surgery, 2 cases without surgery. Surgical diseases were acute inflammation in 6 cases, gastrointestinal cancer in 5 cases, cirrhosis in 2 cases, intestinal fistula in 1 case and chemotherapy in 3 cases. Five of them had diabetes mellitus. Pathogenic bacteria are mainly Candida, especially the most common Candida albicans (12 cases), yeast in 2 cases, the remaining 3 cases to find mold mycelium, undetermined strains. This group of mold from the oral secretions, urine, sputum, wound secretions, implants and other blood samples were smear or mold culture confirmed. One sample found 10 cases, two specimens in 6 cases, 3 specimens confirmed in 1 case. This group made a total of smear find mold 67 times, positive 26 times, the positive rate of 38%. Mold culture 25 times, positive 8 times, the positive rate of 32%. In addition to the original group of patients with symptoms of surgical diseases, there are some unique symptoms of fungal infection. Psychiatric symptoms: apathetic, lethargy, apathetic, trance. Gastrointestinal symptoms: oral mucosal fungal plaque, glossitis, esophagitis, difficulty swallowing. Respiratory symptoms: Dyspnea, dry cough, fever, pleuritic pain. Body temperature: patients have 38 ℃ ~ 40 ℃ fever, mostly fever, peripheral blood: white blood cells often increased to 20 × 109 / L mostly. Treatment of systemic supportive treatment in the same time, take 1, termination of the promotion of fungal infection treatment. In the original case of disease treatment permit, disable or postpone the use of antibiotics?