ABSTRACT
Objective:To investigate the risk factors of pulmonaryfungal infection in intensive care unit(ICU),and discuss the strategy of prevention and treatment.Methods:Thirty-four patients with pulmonary fungal infection in ICU of our Hospital from Jan.2004 to Jan. 2009 were analyzed retrospectively,including primarily diseases,application of antibiotics,adrenal cortical hormone and virulence opera-tion,therapy and turnover.Results:All patients were accepted the therapies of broad spectrum antibiotics and glucocorticoids for long time before definite diagnosis of pulmonary fungal infection.Theire average time that the patients staying in hospital was 45.6 d.The clinical symptoms and imaging examinations were untypica.l Blastomyces albicans was the main pathogen.After the antifungal agents and supportive treatment used in time,33cases(97%)were cured and 1cases(3%)died.Conclusion:The major risk factors of children pulmonary fungal infection are long-time use of broad spectrum antibiotics and glucocorticoids.The pulmonary fungal infection can decrease by rationaluse of broad spectrum antibiotics and glucocorticoids,decreasing the unnecessary invasive operations,strengthening the supportive therapies ofmicro-ecosystem,and applying the antifungal agents in time.
ABSTRACT
Objectives To investigate the etiological factors,clinical features and treatment of pediatric primary spontaneous pneumothorax (PSP). Methods The clinical data of 84 PSP patients under the age of 18 from Departments of Emergency,Respiratory Diseases and Thoracic Surgery of our hospital from June 1999 to June 2009 were collected. There were 72 males (85.7%) and 12 females (15.3%) with a ratio of 6 to 1. Their age ranged from 14 to 18 (mean 17.06). Patients with pneumothorax following trauma,pneumonia,iatrogenic and other underlying causes were excluded. Therapeutic methods included oxygen therapy for 4.8% patients,closed drainage of pleural cavity for 57.1% patients,and surgery for 38.1% patients,But there were 31 patients receiving surgical treatment after closed drainage was failed. The period of follow-up ranged from 1 to 123 months (mean 25.73 months) through telephone or outpatient. Results Eighty-four patients were included,of whom 96.4% had chest pain,7.1% had chest tightness,66.7% had dyspnea,8.3% had shortness of breath and 14.3% had cough. There were 96.4% patients having decreased breathing sound and 3.6% having absent breathing sound. Bullae or blebs occurred mostly in apex and upper lobe. Twenty-one patients suffered from recurrent pneumothorax. Smokers (66.7%,n=9) had higher recurrent rate than non-smokers (22.0%,n=75). Conclusion PSP should be considered when symptoms such as chest pain and dyspnea appear in teenagers. Closed drainage of pleural cavity combined with surgical procedure is recommended for treatment. PSP patient with a history of smoking has higher recurrent rate of PSP.