鼻脑型毛霉病2例及相关文献分析

摘要/Abstract

摘要： 目的加强对鼻脑型毛霉病的认识，早诊断、早治疗，制定恰当的治疗方案以提高患者生存率。方法对我科协助治疗的2例继发于血液系统疾病的鼻脑型毛霉病患者的诊断、治疗及预后结合回顾相关病例文献进行分析。结果 2例患者均为确诊病例，均发生于血液系统疾病缓解期，给予两性霉素B静滴及外用湿敷抗真菌治疗，并择期进行手术治疗。2例患者的皮肤感染得到控制，但最终仅1例救治成功。汇总文献中61例鼻脑型毛霉病例显示52例患者两性霉素B静滴及外科手术联合治疗，死亡率达55.8%，高危因素是未受控制的糖尿病、血液系统疾病或实体器官移植，并常因误诊而导致治疗失败。结论血液系统疾病合并鼻脑型毛霉病死亡率高，尽早诊断、制定有效治疗方案及选择合适的手术时机有助于提高患者生存率。

关键词: 鼻脑型毛霉病, 两性霉素B, 局部治疗, 发病机制, 手术

Abstract: Objective To improve the understanding of mucormycosis of nostril-brain type. Methods The diagnosis, treatment and prognosis of 2 cases of rhinocerebral mucormycosis secondary to hematologic diseases which we assisted the treatments were analyzed. Relevant case literatures were also reviewed. Results All 2 cases were confirmed to be in remission stage of hematologic disease. Amphotericin B intravenous drip and external wet compress were used. Skin infection was controlled in 2 cases, but only 1 case was successfully treated. A review of 61 cases of rhinocerebral mucormycosis showed that 52 patients had been treated with amphotericin B and surgery and the mortality rate of this group was 55.8%. The high risk factors included uncontrolled diabetes and hematopathy or solid organ transplantation. Conclusion The mortality rate of hematologic diseases combined with mucormycosis was high. Early diagnosis, effective treatment and appropriate operation timing can improve the survival rate of patients.

Key words: rhinocerebral mucormycosis, amphotericin B, local treatment, pathogenesis, surgery

中图分类号:

R519.8

马舒君, 张芙蓉, 陶苏江, 余永涛, 王英. 鼻脑型毛霉病2例及相关文献分析[J]. 中国真菌学杂志, 2022, 17(2): 109-114.

MA Shujun, ZHANG Furong, TAO Sujiang, YU Yongtao, WANG Ying. Analysis of 2 cases of mucormycosis and related literature[J]. Chinese Journal of Mycology, 2022, 17(2): 109-114.

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