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目的 :探讨原发毛霉菌病临床特征、诊断及治疗。方法 :分析本院1例原发肺型毛霉菌病播散感染的临床资料,回顾分析CNKI及Pub Med数据库中原发毛霉菌病的临床特征。结果:文献报道共13例患者,男8例、女5例,男女比例1.6∶1,发病年龄17~75岁,平均年龄37.92岁;病程1 d~12年,平均1.5年;其中肺型4例(30.77%)、皮肤型4例(30.77%)、鼻眼脑型3例(23.08%)、播散型2例(15.38%);病理诊断10例(76.92%),病原学联合病理诊断3例(23.08%);单纯外科清创治疗2例(15.38%),抗真菌治疗6例(46.15%),清创联合抗真菌治疗5例(38.46%);治愈9例(69.23%),死亡4例(30.77%)。结论 :原发毛霉菌病是一种罕见病死率较高的侵袭性真菌病,早期诊断并及时行两性霉素B联合外科清创治疗是抢救成功的关键。
Objective: To investigate the clinical features, diagnosis and treatment of primary hairy mildew. Methods: The clinical data of one primary pulmonary mucormycosis in our hospital were analyzed. The clinical features of primary hairy mildew in CNKI and Pub Med were analyzed retrospectively. Results: A total of 13 patients were reported in the literature, including 8 males and 5 females, with a male-to-female ratio of 1.6: 1. The age of onset was 17 to 75 years, with an average age of 37.92 years. The course of disease ranged from 1 to 12 years (mean 1.5 years) (30.77%), skin type in 4 cases (30.77%), nasopharyngeal brain type in 3 cases (23.08%), disseminated type in 2 cases (15.38%), pathological diagnosis in 10 cases (76.92% 3 cases (23.08%), 2 cases (15.38%) with pure debridement, 6 cases with antifungal therapy (46.15%), 5 cases with antifungal debridement (38.46%), 9 cases (69.23% 4 died (30.77%). Conclusion: The primary hairy mildew is a rare case of invasive mycosis with high mortality. Early diagnosis and prompt amphotericin B combined with surgical debridement are the keys to successful salvage.