摘要:
目的:探究慢性重型肝炎并发侵袭性肺部真菌感染的CT影像学特征,为患者的诊断和治疗提供依据。方法:选择2014年10月至2016年10月收治的慢性重型肝炎并发侵袭性肺部真菌感染患者92例,随机分为两组,各46例。对照组实施常规治疗,观察组在常规治疗的基础上加以氟康唑治疗。比较两组治疗前后CT影像学特征。结果:所有92例慢性重型肝炎并发侵袭性肺部真菌感染患者,共培养出176株病原菌。两组菌种均以假丝酵母菌属所占比例最高,对照组为44.44%,观察组为41.05%,其次为曲霉菌属,两组患者中所有病原菌的分布差异无统计学意义(P>0.05)。治疗后,观察组结节、磨玻璃影、网格或线样及胸腔积液比例相比于对照组,显著降低,差异有统计学意义(P<0.05)。所有患者中42例为曲霉菌属感染,35例为假丝酵母菌感染。假丝酵母菌与曲霉菌属感染患者在结节类型及个数之间的差异有统计学意义(P<0.05)。结论:对慢性重型肝炎并发侵袭性肺部真菌感染患者行CT诊断具有重要临床价值,假丝酵母菌属及曲霉菌属为主要病原菌,且各病原菌感染患者的CT影像学特征各不相同。
Abstract:
Objective: To explore CT imaging features of chronic severe hepatitis complicated with invasive pulmonary fungal infection and provide the basis for the diagnosis and treatment of patients. Methods: 92 patients with chronic severe hepatitis complicated with invasive pulmonary fungal infection from October 2014 to October 2016 were randomly divided into two groups (n=46). The control group was treated with conventional therapy, and the observation group was treated with fluconazole on the basis of routine treatment. The CT imaging features of the two groups before and after treatment were compared. Results: All 92 patients with chronic severe hepatitis complicated with invasive pulmonary fungal infection, a total of 176 strains of pathogens were cultured. The percentage of Candida species was the highest in the two groups, 44.44% in the control group and 41.05% in the observation group, followed by Aspergillus, the distribution of all pathogens in the two groups was not statistically significant (P 〉 0.05). After treatment, the proportion of nodule, ground glass, grid or line and pleural effusion in the observation group was significantly lower than that in the control group (P 〈 0.05). Of the patients, 42 were aspergillous and 35 were Candida infections. There were significant differences in the type and number of nodules between patients with Candida and Aspergillus infection (P 〈 0.05). Conclusion: It is important to diagnose CT in patients with chronic severe hepatitis complicated with invasive pulmonary fungal infection. Candida and Aspergillus are the main pathogens, and the CT imaging features of patients with different pathogens are different.
百度学术
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