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齐瑶; 赵明峰; 邓琦; 耿莉
中华血液学杂志, 2019, Volume: 40, Issue: 11Journal Article
目的 探讨血液病合并毛霉菌病患者的临床特征、诊治与转归,提高对该病的认识.方法 回顾性分析2012年9月至2018年9月7例血液病合并毛霉菌病患者的临床资料,分析其临床特征、治疗过程和转归.结果 7例血液病合并毛霉菌病患者中,男4例,女3例,中位年龄36(19~79)岁.基础疾病:急性髓系白血病2例,急性B淋巴细胞白血病、外周T细胞淋巴瘤、慢性髓性白血病急髓变、骨髓增殖性肿瘤及重型再生障碍性贫血(移植后)各1例.毛霉菌病临床类型:4例为肺型,1例为鼻眶脑型,1例为皮肤型,1例为播散型.7例患者均通过活检组织病理确诊.治疗药物为两性霉素B、两性霉素B脂质体及泊沙康唑.手术治疗4例,其中3例术中彻底清除病变组织,1例仅行局限性清除.治愈2例,好转1例,死亡4例.结论 血液病合并毛霉菌病患者临床表现及影像学表现多样,死亡率高,确诊主要依赖于组织病理学.早期诊断、控制基础疾病、改善免疫抑制状态、尽早行有效的抗真菌药物治疗及彻底的手术清创治疗是提高血液病合并毛霉菌病患者生存率的关键.
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