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肾移植术后院内与院外肺部感染的分析
引用本文:侯瑞鹏,石炳毅,易滨,柏宏伟,赵豫波.肾移植术后院内与院外肺部感染的分析[J].中华医院感染学杂志,2008,18(1):53-55.
作者姓名:侯瑞鹏  石炳毅  易滨  柏宏伟  赵豫波
作者单位:1. 解放军总医院第二附属医院全军器官移植中心,北京,100091
2. 解放军总医院第二附属医院感染监控室,北京,100091
摘    要:目的探讨肾移植术后院内与院外肺部感染的特点与治疗措施。方法对21例肾移植术后发生肺部感染患者的临床资料进行回顾性分析。结果21例患者中院内感染13例,院外感染8例;19例检出病原菌,其中细菌感染有17例次(院内感染7例,院外感染10例)占47.22%;单纯感染4例,混合感染15例占检出病原菌的78.95%(院内感染均为混合性);4例患者(19.05%)出现急性呼吸窘迫综合征,行机械通气;21例中死亡3例均为院内感染,治愈18例。结论肾移植术后肺部感染已成为威胁患者生命的主要原因之一,应及早发现、果断治疗,了解院内、院外感染的区别,及时正确使用呼吸机,调整免疫抑制剂和全身支持疗法是治疗成功的关键。

关 键 词:肾移植  肺部感染  院内感染  院外感染  肾移植术后  术后肺部感染  分析  Kidney  Transplantation  Patients  断治疗  支持疗法  免疫抑制剂  调整  使用呼吸机  发现  治愈  死亡  机械通气  急性呼吸窘迫综合征  混合性  混合感染  单纯感染  细菌感染  病原菌
文章编号:1005-4529(2008)01-0053-03
收稿时间:2007-08-11
修稿时间:2007-11-10

Nosocomial and Community-acquired Pulmonary Infection in 21 Patients after Kidney Transplantation
HOU Rui-peng,SHI Bing-yi,YI Bin,BAI Hong-wei,ZHAO Yu-bo.Nosocomial and Community-acquired Pulmonary Infection in 21 Patients after Kidney Transplantation[J].Chinese Journal of Nosocomiology,2008,18(1):53-55.
Authors:HOU Rui-peng  SHI Bing-yi  YI Bin  BAI Hong-wei  ZHAO Yu-bo
Abstract:OBJECTIVE To study the features and treatment of nosocomial pulmonary infection and community-acquired pulmonary infection in patients after kidney transplantation.METHODS The clinical data of pulmonary infection in 21 patients following kidney transplantation were analyzed retrospectively.RESULTS From them 13 cases were with nosocomial pulmonary infection and 8 cases with community-acquired pulmonary infection.Microorganisms were isolated and identified in 19 patients.Among them there were 17 infected cases(47.22%;7 with nosocomial pulmonary infection and 10 with community-acquired pulmonary infection).Four cases were with a simple infection and 15 cases with mixed infection(78.95%).All nosocomial pulmonary infection was mixed.Four cases took the mechanical ventilation(19.05%) and all of them caught acute respiratory distress syndrome(ARDS).Three cases who caught infection in hospital died and 18 cases were cured.CONCLUSIONS The pulmonary infection after kidney transplantation has become one of the main reasons which threaten patients lives.The key points of succeesful treatment are early diagnosis,quick administration,understanding the difference between nosocomial infection and community-acquired infection,timely using of mechanical ventilation in the right way,and adjusting dose of immunosuppressant and maintenance therapy.
Keywords:Kidney transplantation  Pulmonary infection  Nosocomial infection  Community-acquired infection
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