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The novel coronavirus is a newly discovered pathogen in late December 2019, and its source is currently unknown, which can lead to asymptomatic infection, new coronavirus pneumonia or serious complications, such as acute respiratory failure. Corona virus disease 2019 (COVID-19) is a new type of respiratory disease that is currently spreading all over the world and caused by this coronavirus. Its common symptoms are highly similar to those of other viruses, such as fever, cough and dyspnea. There is currently no vaccine or treatment for COVID-19. Everyone is susceptible to infection with this disease, and owing to the long-term use of immunosuppressants, the immunity of kidney transplant recipients is suppressed, and it is more likely to be infected with the disease. At present, its impact on kidney transplant recipients is unclear. This article reports the clinical features and therapeutic course of novel coronavirus infection in a patient after renal transplantation. A 37-year-old female patient who received a kidney transplant 6 months before was diagnosed with novel coronavirus pneumonia. The patient’s symptoms (such as fever, chills, dry cough, muscle aches), laboratory tests (such as decreased white blood cell count, elevated liver enzymes and D-dimer, positive viral nucleic acid test), and chest CT (multiple left lower lung plaque ground glass shadow) were similar to those of non-transplanted novel coronavirus pneumonia patients. In terms of treatment, because the immunity of kidney transplant recipients has been suppressed for a long time, it is a very common strategy to suspend the use of immunosuppressive agents. Therefore, the patient immediately discontinued the immunosuppressive agent after admission, so that she could restore immunity against infection in a short time. At the same time, the use of glucocorticoids was also very important. Its immunosuppressive and anti-inflammatory effects played a large role in the treatment process.In addition, prophylactic antibiotics was needed, and nephrotoxic drugs should be used with caution. Finally, following discounting the use of immunosuppressant and a low-dose glucocorticoid-based treatment regimen, COVID-19 in this renal transplant recipient was successfully cured. The cure of this case was of great significance, and this adjuvant nonspecific antiviral therapy could provide a template for the treatment of other such patients. 相似文献
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目的:探讨影响肝移植术后机械通气撤离时间的相关因素。方法:根据术后24h内是否可以撤离机械通气,将96例肝移植术后患者分为两组。以术前、术中及术后常用的临床及实验室18项指标作为相关影响因素的分析对象,进行单因素分析,将单因素分析有统计学意义的指标再进行stepwise logistic回归分析。结果:患者术前CHILD分级、手术时间、术中输液量、术中出血量、术中输血量、术中尿量、术中低血压持续时间、术后肾功能衰竭8项指标两组间的差异有统计学意义(P〈0.05);术中失血量、术中尿量和术后肾功能衰竭是三个独立相关影响因素。结论:影响肝移植患者术后机械通气时间的因素是多方面的,术中出血量多、尿量减少、术后出现肾功能不全是相关独立影响因素。 相似文献
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重症监护病房革兰阴性杆菌耐药性监测与分析 总被引:7,自引:0,他引:7
目的了解重症监护病房(ICU)革兰阴性杆菌对临床常用抗菌药的耐药性变化,以指导合理选择抗菌药物。方法采用纸片扩散法对2003年1月-2004年12月我院ICU分离出的革兰阴性杆菌进行药敏检测,按NCCLS2003年版标准判断结果。结果2年中分离出245株革兰阴性杆菌,其中以不动杆菌(48.2%)和铜绿假单胞(11.0%)为主的非发酵菌占65.3%,74.5%来自痰液标本。亚胺培南的总敏感率最高(93.9%),对除嗜麦芽窄食单胞菌外的其他革兰阴性杆菌具有很好的抗菌活性;革兰阴性杆菌对头孢他啶、头孢哌酮-舒巴坦、头孢吡肟、哌拉西林-三唑巴坦和阿米卡星的敏感率多数为44%~68%,对其他抗菌药高度耐药;头孢他啶和复方磺胺甲嘿唑对嗜麦芽窄食单胞菌的敏感率高达73.3%。大肠埃希菌和肺炎克雷伯菌产ESBLs菌株分别占26.3%和32.3%;产酶菌株对多数常用抗菌药物耐药率高于非产酶菌株,对亚胺培南无耐药,头孢哌酮-舒巴坦和哌拉西林-三唑巴坦对产ESBLs菌株抗菌活性明显强于其他头孢菌素。结论非发酵菌在从ICU分离出的革兰阴性杆菌中占有较高比例,亚胺培南对除嗜麦芽窄食单胞菌外的其他革兰阴性杆菌具有较好的抗菌活性,其他抗菌药物抗菌活性较低。 相似文献
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目前,危重病患者生存面临的最大威胁是脓毒症,几十年来其平均死亡率高达40%,而且为降低高死亡率而进行的各种努力并无实质性政善。如何降低脓毒症的高患病率、高病死率已成为目前危重病医学最严峻的挑战之一。近年通过对机体免疫炎症反应紊乱本质的进一步研究及认识的深化,提出了基于炎症反应、免疫功能紊乱是脓毒症发生和发展的中心环节而进行的抗炎、免疫调理治疗,现就脓毒症的免疫功能紊乱与免疫调理治疗进行综述。 相似文献
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目的 探讨老年肾功能不全患者应用利奈唑胺抗革兰阳性球菌感染的疗效及其对血小板的影响.方法 对2009年8月-2011年10月急诊重症监护病房(EICU)和危重医学科、应用利奈唑胺治疗革兰阳性球菌感染的老年肾功能不全患者进行回顾性分析.结果 27例患者使用利奈唑胺的疗程为3~16 d,平均(9.75±3.54)d,临床有效率为77.8%,革兰阳性球菌清除率为93.5%;血小板减少发生率为70.4%,其中血小板减少25.0%~50.0%的占22.2%,减少>50.0%的占48.2%,血小板计数最低值≤50×109/L占18.5%;患者年龄>80岁、基础血小板计数越低、肾功能不全越严重,发生血小板减少的时间可能越早.结论 利奈唑胺治疗老年肾功能不全患者革兰阳性球菌感染,疗效确切,但要高度警惕发生血小板减少的可能. 相似文献
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1998~2003年北京地区重症监护病房弥漫性血管内凝血的临床流行病学调查 总被引:1,自引:0,他引:1
目的 调查北京地区重症监护病房(ICU)中弥漫性血管内凝血(DIC)的发病情况、原发病、病死率及其影响因素.方法 采用2001年ISTH/SSC DIC专业委员会提出的DIC诊断标准,回顾性调查1998年5月~2003年4月北京地区8所三级综合医院ICU中收治DIC患者.结果 DIC患者87例,占同期ICU收治危重病人的1.03%;其中感染性疾病(39.1%)、创伤(20.7%)、大手术(11.5%)、重症胰腺炎(10.9%)是最常见原发病.DIC总病死率为63.2%,对病死率分别以年龄、性别、APACHE-Ⅱ评分进行调整,调整后5年间的病死率均无显著性差异(P>0.05).单纯DIC患者死亡率为0,DIC患者累及器官越多,死亡率越高.结论 DIC是北京地区ICU中常见危重症,病死率很高,且近年来并未下降,应给予重视. 相似文献