Study The Clinical In Preventing EICU Patients Hospital-Acquired Fungal Pneumonia By Aerosol In Inhalation Of Amphotericin B

Objectives: To investigate the effect on the patients of EICU with hospital-acquired fungal pneumonia by inhalation of Amphotericin B.Methods: 51 newly admitted of EICU patients were randomly divided into group A (nebulization group) and group B(control group). Group A were treated with nebulization 10 mg Amphotericin B, once a day ,until they left EICU. Group B were treated with nebulization 5ml normal saline, once a day ,until they left EICU. At the 1st, 3rd , 7th, 10th, more than 10th days: Both groups were observed : (1)Clinical comprehensive index evaluation: APACHEII score, EICU hospital-acquired pneumonia morbidity rate, EICU hospital-acquired fungal pneumonia morbidity rate, the average EICU hospitalization time, EICU fatality rate, liver and kidney functions, and the adverse effects; (2)Experimental observation index evaluation: The positive rate of sputum, oropharyngeal swabs, blood and urine fungal cultures.Results: (1) Clinical comprehensive index evaluation: APACHEII score, EICU hospital-acquired pneumonia morbidity rate, EICU hospital-acquired fungal pneumonia morbidity rate, the average EICU hospitalization time, EICU fatality rate and the adverse effects, and respectively through both groups comparison, there were no difference between the two groups at the each time quantum(APACHEII score at the each time quantum(group A(14.1±5.7) VS group B(15.5±7.2), p>0.05,group A(11.9±6.8) VS group B (12.7±7.1), p>0.05,group A(11.8±8.7) VS group B(11.6±8.2), p>0.05,group A(11.5±6.7)VS group B(12.5±8.6), p>0.05,group A(10.3±7.1) VS group B(13.7±11.5), p>0.05);EICU hospital-acquired pneumonia morbidity rate at the each time quantum( group A (12.0%) VS group B (7.7%), p>0.05,group A (12.0%) VS group B (11.5%), p>0.05,group A (14.3%) VS group B (18.7%), p>0.05,group A (14.3%) VS group B (14.3%), p>0.05);EICU hospital-acquired fungal pneumonia morbidity rate at the each time quantum(group A (0%)VS group B (0%),p>0.05,group A(4%)VS B组(3.8%),p>0.05,group A (7.1%)VS group B (6.2%),p>0.05,group A (0.0%)VS group B (14.3%),p>0.05);the average EICU hospitalization time: group A(9.3±3.6) VS group B(10.7±6.3), p>0.05 ;EICU fatality rate( group A (12.0%) VS group B (15.4%), p>0.05); Serum creatinine levels at the each time quantum: group A(239.4±335.0) VS group B(189.0±179.0), p>0.05,group A(194.0±208.9) VS group B(141.1±164.4), p>0.05,group A (190.7±192.2) VS group B(129.8±141.3), p>0.05,groupA(175.6±226.4) VS group B(115.7±131.8), p>0.05,group A (93.1±45.0) VS group B (136.2±193.4), p>0.05;Serum total bilirubin levels at the each time quantum(group A(19.7±16.7) VS group B(36.2±83.0), p>0.05,group A (15.2±9.1) VS group B(21.4±37.9), p>0.05,group A(15.9±10.0) VS group B(18.6±30.1), p>0.05,group A(14.8±11.1) VS group B (15.8±8.5), p>0.05,group A(14.2±7.5) VS group B(19.7±11.5), p>0.05 )。(2)Experimental observatory index evaluation: The positive rate of sputum, oropharyngeal swabs fungal cultures compaired: There were no difference between the two groups at the 1st, 3 rd more than 10th days( groupA(16.5%) VS group B(11.5%), p>0.05,group A (24.0%) VS group B (34.6%), p>0.05,group A (28.6%)VS group B (57.2%), p>0.05),when group A were significantly lower than group B at the 7th,and 10 th days (group A (20.0%) VS group B (46.2%), p<0.05,group A (21.4%)VS group B (62.5%), p<0.05); The positive rate of urine fungal cultures compaired: These were no difference between the two groups at the each time quantum(group A (0.0%) VS group B (0.0%), p>0.05,group A (8.0%) VS group B (3.8%), p>0.05,group A (12.0%) VS group B (3.8%), p>0.05,group A (14.3%) VS group B (3.8%), p>0.05,group A (0.0%) VS group B (0.0%), p>0.05); the positive rate of blood fungal cultures compaired: During period of treatment ,both groups did not find out any a part positive samples。Conclusions: (1) Nebulization of Amphotericin B can not decrease EICU hospital-acquired fungal pneumonia morbidity rate ;(2) Nebulization of Amphotericin B can decrease the positive rate of sputum, oropharyngeal swabs fungal cultures; (3) Nebulization of Amphotericin B is safe, convenient.