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
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摘要
目的探讨慢性阻塞性肺疾病(COPD)合并肺部真菌感染患者的危险因素,并探讨其护理对策。方法选择浙江中医药大学附属第三医院2016年5月—2017年1月间收治的84例COPD合并肺部真菌感染患者为感染组,210例COPD未合并肺部真菌感染患者为未感染组。制作危险因素调查表,对2组年龄、性别、吸烟史、住院时间、合并糖尿病、机械通气、抗生素使用时间、长期使用糖皮质激素、低蛋白血症、呼吸衰竭等情况进行统计,并采用单因素和多因素分析确定COPD合并肺部真菌感染患者的危险因素。结果单因素分析显示,年龄、住院时间长、合并糖尿病、机械通气、长期服用糖皮质激素、使用抗生素时间、呼吸衰竭、低蛋白血症为COPD患者出现肺部真菌感染的危险因素。多因素Logistic分析结果表明,年龄、住院时间长、合并糖尿病、机械通气、长期服用糖皮质激素、使用抗生素时间、呼吸衰竭、低蛋白血症为COPD患者出现肺部真菌感染的危险因素。结论 COPD患者临床易发生肺部真菌感染。其中,年龄、住院时间长、合并糖尿病、机械通气、长期服用糖皮质激素、使用抗生素时间、呼吸衰竭、低蛋白血症为COPD出现肺部真菌感染的危险因素,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 patients with chronic obstructive pulmonary disease( COPD) with pulmonary fungal infection. Methods A total of 84 patients with COPD complicated with pulmonary fungal infection treated from May,2016 to January,2017 were selected as the infection group,and 210 patients with COPD without pulmonary fungal infection were selected as uninfected group. The risk factors questionnaire was made,and the age,sex,smoking history,long hospital stay,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoids,hypoproteinemia,respiratory failure of two groups were accounted. The univariate and multivariate analysis were used to determine the risk factors for COPD patients with pulmonary fungal infection. Results Univariate results showed that age,hospitalization time,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoid,hypoproteinemia and respiratory failure were the risk factors of pulmonary fungal infection in COPD patients. Multivariate logistic regression analysis showed that age,length of stay,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoid,hypoproteinemia and respiratory failure were risk factors for pulmonary fungal infection in COPD patients. Conclusion COPD patients are prone to pulmonary fungal infection.age,length of hospital stay,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoids,hypoproteinemia,respiratory failure are risk factors for pulmonary fungal infection in patients with COPD. So those risk factors should attract attention and treatment and nursing should be done well to prevent the occurrence of fungal infection.
Objective To investigate the risk factors and nursing strategies of patients with chronic obstructive pulmonary disease( COPD) with pulmonary fungal infection. Methods A total of 84 patients with COPD complicated with pulmonary fungal infection treated from May,2016 to January,2017 were selected as the infection group,and 210 patients with COPD without pulmonary fungal infection were selected as uninfected group. The risk factors questionnaire was made,and the age,sex,smoking history,long hospital stay,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoids,hypoproteinemia,respiratory failure of two groups were accounted. The univariate and multivariate analysis were used to determine the risk factors for COPD patients with pulmonary fungal infection. Results Univariate results showed that age,hospitalization time,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoid,hypoproteinemia and respiratory failure were the risk factors of pulmonary fungal infection in COPD patients. Multivariate logistic regression analysis showed that age,length of stay,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoid,hypoproteinemia and respiratory failure were risk factors for pulmonary fungal infection in COPD patients. Conclusion COPD patients are prone to pulmonary fungal infection.age,length of hospital stay,diabetes mellitus,mechanical ventilation,antibiotic use time,long-term use of glucocorticoids,hypoproteinemia,respiratory failure are risk factors for pulmonary fungal infection in patients with COPD. So those risk factors should attract attention and treatment and nursing should be done well to prevent the occurrence of fungal infection.
引文
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[12]温伟杰.COPD患者肺部真菌感染菌株分布及相关危险因素分析[J].临床合理用药杂志,2018,11(1):142-143.
[13]邹冬侠,纪兆放,张腊梅,等.老年慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭病人肺部真菌感染危险因素分析[J].实用老年医学,2017,31(12):1138-1140,1144.
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[2]陈荣昌,高永华.慢性阻塞性肺疾病临床防治与研究热点问题[J].实用医学杂志,2014,30(1):1-3.
[3]张伦碧.老年慢性阻塞性肺疾病合并真菌感染的相关因素分析[J].现代医药卫生,2014,30(11):1750-1752.
[4]中华医学会呼吸病学分会慢性阻塞性肺疾病组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华内科杂志,2007,46(3):123-126.
[5]中华医学会呼吸病学分会感染学组.肺真菌病诊断和治疗专家共识[J].中华结核和呼吸杂志,2007,30(11):821-834.
[6]冉丕鑫.慢性阻塞性肺疾病的危险因素与社区综合防治[J].实用医学杂志,2014,30(1):4-5.
[7]吴驰,黄江,邹俊,等.慢性阻塞性肺疾病合并真菌感染的危险因素与预后[J].西部医学,2014,26(9):1170-1172.
[8]龚峰,叶瑞海,林海.慢性阻塞性肺疾病患者肺部真菌感染危险因素研究[J].中华医院感染学杂志,2014,24(13):3237-3239.
[9]鲍志坚,徐俭朴,陈爱凤.慢性阻塞性肺疾病患者继发肺部真菌感染危险因素分析[J].中华医院感染学杂志,2014,24(17):4245-4247.
[10]Ghanem M,Zein A,Makhlouf H,et al.Role of Comorbidities in Acquiring Pulmonary Fungal Infection in COPD Patients[J].Chest,2016,150(4):915A.
[11]余芳,戴晴霞,金珠凤.加强护理对慢性阻塞性肺病合并真菌感染的影响[J].中外医疗,2014,33(28):6-8.
[12]温伟杰.COPD患者肺部真菌感染菌株分布及相关危险因素分析[J].临床合理用药杂志,2018,11(1):142-143.
[13]邹冬侠,纪兆放,张腊梅,等.老年慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭病人肺部真菌感染危险因素分析[J].实用老年医学,2017,31(12):1138-1140,1144.
[14]张新,汪秀芹,王焱,等.慢性阻塞性肺疾病继发肺部真菌感染56例临床分析[J].中国综合临床,2014,30(10):1027-1030.
[15]杨永静.慢性阻塞性肺疾病患者合并肺部真菌感染的综合护理[J].中华肺部疾病杂志(电子版),2014,7(5):60-61.