發(fā)布時間：2018-12-21 08:00

【摘要】：目的對諾卡菌培養(yǎng)陽性病例的臨床特點進行分析,提高對諾卡菌病的認識。方法回顧性分析寧夏醫(yī)科大學(xué)總醫(yī)院2012年5月至2016年5月住院患者標(biāo)本培養(yǎng)為諾卡菌陽性的患者的臨床資料。結(jié)果20例諾卡菌培養(yǎng)陽性病例中3例考慮污染所致,其余17例為不同部位感染,其中2例為播散性感染,12例為肺部感染,2例為軟組織感染,1例為透析相關(guān)性腹膜炎;17例均合并基礎(chǔ)疾病,其中7例因基礎(chǔ)病使用糖皮質(zhì)激素或免疫抑制劑。17例中2例死亡,余15例經(jīng)復(fù)方新諾明、米諾環(huán)素、阿米卡星、美羅培南、三代頭孢等治療后病情好轉(zhuǎn)出院;隨訪9例痊愈,其中5例口服復(fù)方新諾明片聯(lián)合或不聯(lián)合米諾環(huán)素片治療6個月到15個月不等,4例病情反復(fù),其中3例合并支氣管擴張,2例失訪。結(jié)論諾卡菌可引起全身各部位感染,以肺為常見。有基礎(chǔ)疾病者易發(fā)生諾卡菌感染,尤其使用糖皮質(zhì)激素及免疫抑制劑患者。諾卡菌病無特異臨床表現(xiàn)。治療一線藥物為磺胺類,氨基糖苷類、三代頭孢等亦為可選藥物。諾卡菌病的預(yù)后感染部位、有否基礎(chǔ)疾病、治療及時否等因素有關(guān)。
[Abstract]:Objective to analyze the clinical characteristics of positive cases of Nocardial bacilli culture and to improve the understanding of Nocardiosis. Methods the clinical data of Nocardial bacillus positive specimens cultured from May 2012 to May 2016 in General Hospital of Ningxia Medical University were analyzed retrospectively. Results among the 20 cases of positive culture of Nocardial bacillus, 3 cases were caused by contamination, the other 17 cases were infected by different sites, 2 cases were disseminated infection, 12 cases were pulmonary infection, 2 cases were soft tissue infection, and 1 case was dialysation-associated peritonitis. Among the 17 cases, 7 cases were treated with glucocorticoid or immunosuppressant, 2 cases died, the remaining 15 cases were treated with compound sulfamine, minocycline, amikacin, meropenem. After the third generation of cephalosporal treatment, the condition was improved and discharged. 9 cases were followed up. Among them, 5 cases were treated with or without minocycline compound tablets for 6 months to 15 months, 4 cases were repeated, 3 cases were complicated with bronchiectasis and 2 cases lost their visits. Conclusion Nocardial bacillus can cause infection in all parts of the body, and the lung is the most common infection. People with underlying diseases are prone to Nocardial infections, especially with glucocorticoids and immunosuppressants. Nocariasis has no specific clinical manifestations. The first-line drugs are sulfanilamide, aminoglycosides and third generation cephalosporins. The prognosis of nocariasis infection site, whether the underlying disease, timely treatment and other factors related to.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R519.1

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