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目的观察应用小剂量氟康唑预防极低出生体重儿侵袭性真菌感染的作用。方法采用回顾性对照分析的方法,选取2011年1月至2014年12月出生于我院并在我院新生儿重症监护病房住院的极低出生体重儿,前2年未预防应用氟康唑的患儿为对照组,后2年预防性应用氟康唑的患儿为预防组。所有患儿入院后均给予保暖、监护、抗感染、肠外营养等对症支持治疗。预防组患儿生后第3天起给予氟康唑针3 mg/(kg·d)静脉滴注,同时观察使用氟康唑后的肝功能及消化道不良反应,比较两组住院期间侵袭性真菌感染发生率。结果对照组共纳入104例,预防组共纳入106例,两组患儿胎龄、性别、出生体重、广谱抗生素使用时间、肠外营养时间、住院时间等方面差异均无统计学意义(P>0.05)。预防组发生侵袭性真菌感染1例(0.9%),对照组发生侵袭性真菌感染8例(7.7%),两组差异有统计学意义(χ~2=5.829,P<0.05);预防组用药后2、4、6周肝功能及消化道不良反应与对照组相应日龄差异无统计学意义(P>0.05)。结论应用小剂量氟康唑可显著降低极低出生体重儿侵袭性真菌感染的发生,且无明显肝功能及消化道不良反应。
Objective To observe the effect of low dose fluconazole in preventing invasive fungal infection in very low birth weight infants. Methods Retrospective comparative analysis method was used to select very low birth weight infants born in our hospital from January 2011 to December 2014 and admitted to neonatal intensive care unit in our hospital. Fluconazole was not given in the first 2 years Children as control group, prophylactic use of fluconazole 2 years after the prevention group. All children admitted to the hospital were given warm, guardianship, anti-infective, parenteral nutrition and other symptomatic and supportive treatment. The prophylaxis group was given intravenous drip of fluconazole 3 mg / (kg · d) on the third day after birth, and liver function and gastrointestinal adverse reactions after the use of fluconazole were observed. The in-hospital invasiveness Fungal infection incidence. Results There were 104 cases in the control group and 106 cases in the prevention group. There was no significant difference in gestational age, sex, birth weight, time of using broad-spectrum antibiotics, parenteral nutrition time and hospitalization time between the two groups (P > 0.05). One case (0.9%) had invasive fungal infection in the prevention group and eight cases (7.7%) had invasive fungal infection in the control group, the difference was statistically significant (χ ~ 2 = 5.829, P <0.05) There was no significant difference in the liver function and digestive tract adverse reactions at 2, 4, and 6 weeks after treatment with the corresponding control group (P> 0.05). Conclusion Low-dose fluconazole can significantly reduce the incidence of invasive fungal infection in very low birth weight infants with no obvious liver dysfunction and gastrointestinal adverse reactions.