肝移植术后的细菌感染

目的观察原位肝移植术后细菌感染的特点和相关因素，总结诊断和治疗经验。方法回顾分析我院2000年12月至2002年12月治疗的17例肝移植受体的细菌感染率、感染部位、常见致病菌和耐药情况。结果肝移植术后15例(88．2％)发生34次细菌感染，以肺部感染和腹腔感染多见。手术时间延长、伴随糖尿病及胆道狭窄的发生分别与腹腔、泌尿系和胆道细菌感染有关。多种细菌混合感染、院内感染、条件致病菌所致感染比例大，耐药菌株检出率高。结论细菌感染是肝移植术后的主要并发症之一，手术时间延长、伴随糖尿病及胆管狭窄的发生是细菌感染的相关因素。有效的预防、早期确诊和治疗是控制细菌感染的关键。

Bacterial infection after liver transplantation

Objective To investigate the features and risk factors of bacterial infection after liver transplantation and summarize our experience in its diagnosis and treatment. Methods The incidence and sites of postoperative bacterial infections as well as species and resistance of bacteria in 17 patients receiving liver transplantation from December 2000 to December 2002 were retrospectively analyzed. Results Bacterial infections developed in 15 (88.2%) patients. The most common sites of infections were lung and abdomen. Intro-abdominal infections were related to long operative time. Urinary tract infections were found in patients with diabetes mellitus and cholangitis was associated with stricture of bile duct. Nosocomial, opportunistic and mixed infection rates were increased after liver transplantation. The detection rate of drug-resistant bacterial strains was high. Conclusions Bacterial infection is a major complication after liver transplantation. Long operative duration, diabetes mellitus and stricture of bile duct are risk factors of bacterial infection. Prevention, early diagnosis and treatment of the infection are very important.