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目的:探讨依曲康唑与广谱抗菌药同步应用预防医院内深部真菌感染的效果。方法:97例中重度以上肺部感染或泌尿系感染者(治疗前痰或中段尿培养及或痰涂片有真菌者不入选)随机分成2组(1)治疗组:65例静脉用抗菌药治疗加口服依曲康唑100 mg·d-1;(2)对照组:32例静脉用抗菌药治疗。所有病例均选用两种抗菌药联合抗细菌感染治疗,疗程均为2用。治疗前后及治疗过程中每周抽血查肝功能,并记录症状,所有患者于治疗前后或治疗过程中病情无好转或反复或伴腹泻时均留痰及或大便送检涂片查霉菌及培养。结果:治疗组65例在治疗期间及疗程后有63例无深部真菌感梁发生;另有2例出现痰涂片查到酵母样菌,但痰培养阴性,其病情的好转进程未受影响。对照组32例中有18例(56．3％)并发真菌(白色念珠菌)感染,其中继发肺部真菌感染16例;肠道真菌感染2例。两组发生肝酶升高无差异。结论:依曲康唑与抗菌药同步应用对院内深部真菌感染的发生有预防作用。
Objective: To investigate the synergistic effect of itraconazole and broad-spectrum antimicrobial agents in the prevention of deep fungal infections in hospitals. Methods: One hundred and ninety-seven patients with moderate or severe pulmonary infection or urinary tract infection (sputum or middle urine culture or sputum smear with fungi were not included) were randomly divided into two groups (1): 65 cases of intravenous antibiotics Treatment plus oral itraconazole 100 mg · d-1; (2) control group: 32 cases of intravenous antibiotics. All cases were selected two antibacterial drugs combined with anti-bacterial treatment, treatment are 2. Before and after treatment and during the treatment of blood to check the liver function weekly, and record the symptoms, all patients before or after treatment or during the disease did not improve or repeated or with sputum or stool when the sputum are still smear smear mold and culture . Results: Sixty-five patients in the treatment group had no deep fungal leiomyelia during the treatment and after the course of treatment. In another two cases, the yeast-like bacteria were found in the sputum smear but the sputum culture was negative. The improvement of the disease was not affected. In the control group, 18 cases (56.3%) were complicated with fungus (Candida albicans) infection, of which 16 cases were secondary pulmonary fungal infection and 2 cases were intestinal fungal infection. There was no difference between the two groups in the increase of liver enzymes. Conclusion: Itraconazole and antimicrobial agents simultaneously have a preventive effect on the occurrence of deep fungal infections in the hospital.