摘要
目的 探讨肾移植术后重症肺部感染的临床综合治疗措施效果.方法 对2014年1月至2017年1月收治的57例肾移植术后重症肺部感染病例的特点及综合治疗效果进行回顾性分析总结.结果 57例受者中45例治愈,其中41例受者与移植肾存活,4例肺部感染治愈,肾功能丧失恢复血液透析.4例肺部真菌感染者肺部病变好转,出院继续口服抗真菌药物治疗,1例结核患者明显好转后出院继续口服抗结核药物.死亡5例,其中2例移植肾带功能死亡.2例因经济问题中途放弃治疗出院.57例受者中29例临床培养或检测病原体阳性.结论 肾移植术后重症肺部感染起病急、病情重、发展迅速,尽早给予足量广谱抗生素且联合使用抗真菌,抗病毒药物并及时调整免疫抑制方案和加强营养支持等综合治疗措施,疗效确切,可明显降低移植术后重症肺部感染的死亡率.
Objective To evaluate the curative efficacy of multimodality for severe pulmonary infection （SPI） following kidney transplantation （KT）.Methods Fifty-seven cases of SPI following KT were treated with multimodality therapy in our hospital between Jan.2014 and Jan.2017.The outcome and data were analyzed and evaluated retrospectively.Results Of these 57 patients,45 cases were cured （41 cases were alive with functioning grafts,and 4 cases had grafts loss）.The pulmonary lesions in 4 cases of pulmonary fungal infection were improved and oral anti-fungal drugs were continuously given after discharge.The symptoms in one case of tuberculosis were obviously improved and anti-tuberculosis treatment was given continuously after discharge.There were 5 deaths,including 2 deaths due to functioning grafts loss.Two cases abandoned treatment during therapy because of financial problem.Pathogens could be detected in only 29 cases.Conclusion SPI after KT is an acute important complication with rapid progression.Early and prompt treatment with combined antibiotics,antifungal drugs as well as antivirus is essential.The keys to successful rescue for SPI should also include immunosuppressant reduction,intravenous immunoglobulin and nutrition support.The combined therapy is successful and could reduce mortality of SPI obviously.
作者
洪良庆
李衡
黄正宇
纳宁
韩飞
孙启全
Hong Liangqing , Li Heng , Huang Zhengyu , Na Ning , Han Fei , Sun Qiquan.(Department of Kidney Transplantation, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Chin)
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2018年第4期209-212,共4页
Chinese Journal of Organ Transplantation
基金
广东省科技计划项目基金（2007B031500014）
关键词
肾移植
重症肺部感染
综合治疗
Kidney transplantation
Severe pulmonary infection
Multimodality therapy
