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  • west china medical publishers
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    find Author "董晗" 2 results
    • 一例疑似合并肺癌伴肺內轉移的高毒力肺炎克雷伯菌感染報告及文獻復習

      目的 探討高毒力肺炎克雷伯菌(hypervirulent Klebsilla pneumoniae,hvKP)感染患者的臨床特征、診斷方法和治療過程,提高臨床醫生對 hvKP的認識。方法 回顧性分析1例hvKP感染患者的一般資料、影像學表現和治療方案,并進行相關文獻復習。結果 患者男,52歲,因發熱1+個月入院,入院CT提示:左肺下葉外基底段胸膜下占位伴雙肺散在多發結節,周圍型肺癌伴轉移?炎性?肝S6-7段占位,肝膿腫?痰及肝膿液培養均發現肺炎克雷伯菌,二代測序示肺炎克雷伯菌,故考慮為hvKP感染。根據藥敏結果先后調整抗生素為美羅培南(1.0 g 2次/d)聯合頭孢他啶(3.0 g 2次/d)、左氧氟沙星(0.5 g 1次/d)聯合頭孢他啶(3.0 g 2次/d)、頭孢哌酮鈉舒巴坦鈉聯合阿米卡星治療,并予引流肝膿腫及胸腔積液后,患者癥狀、體征和影像學異常均明顯好轉,隨訪復查,病灶基本吸收。結論 肺炎克雷伯菌肝膿腫合并膿毒性肺栓塞患者,影像表現疑似肺癌伴肺內轉移。針對該類患者,臨床醫生應考慮肺炎克雷伯菌感染可能,盡早獲取病原學證據,同時關注hvKP常見的侵襲部位,結合藥敏試驗及抗生素藥效學/藥代動力學特點,選用合適的抗生素,從而改善疾病預后。

      Release date:2023-09-02 08:56 Export PDF Favorites Scan
    • The impact of COPD with frequent acute exacerbation and respiratory failure on micro-biology in the respiratory tract

      Objective To investigate the characteristics of micro-biology in the respiratory tract in the patients who were suffering acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with/without their respiratory failures as well as with the high/low frequency of exacerbation. MethodsSixty confirmed subjects in the Department of Respiratory and Critical Care in Guizhou Provincial Hospital from Nov. 2021 to Mar. 2022 were chosen and then divided them into two pairs of sub-groups randomly. Sub-group pairs one were based on the frequency of AECOPD: higher frequency and lower frequency. Sub-group pairs two were based on whether the patients were once with respiratory failure or not. 16S rRNA high-throughput sequencing method was used to detect sputum microecology. The Alpha and Beta diversity of each subgroup, and the differences in bacterial composition and relative abundance, were compared. Results For the AECOPD group with low-frequent of exacerbation, its diversity and abundance of microbiology were higher than those group with high-frequent of exacerbation. The group of AECOPD with respiratory failure had lower bacteria micro diversity but abundancy was higher than those group without respiratory failure. ConclusionThe frequency of AECOPD and whether it is with respiratory failure is related to the change of micro-biology in respiratory tract, so such change plays a great role in this disease.

      Release date:2023-09-22 05:51 Export PDF Favorites Scan
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  • 松坂南