肾移植术后肺部感染发病率及诊治分析

目的 :总结我院肾移植术后患者肺部感染发生率及治疗结果。方法 :回顾性分析 2 85例肾移植患者中 2 8例肺部感染的诊断及治疗情况。　结果 :2 85例患者中 2 8例 (9.82 % )肾移植术后肺部感染 ;铜绿假单胞菌、念珠菌属、表皮葡萄球菌及巨细胞病毒 (CMV)是最为常见的病原体。影像学检查是肺部感染诊断的重要手段 ,但各种病原体之间并不存在明显的特异性。本组患者治愈 10例 (35 .71% ) ,好转 9例 (32 .14 % ) ,死亡 9例 (32 .14 % ) ;2 6例肺部感染出现在术后 4个月前 ,而术后 2～ 4个月是肺部感染致死亡的高发时间段。　结论 :肾移植患者肺部感染、重症肺部感染及病死率都明显高于免疫力正常的人群。采用对常见病原体的经验治疗和病因学的特殊治疗相结合的方法 ,是目前对该类患者治疗及降低病死率的主要措施。

Analysis of morbidity, diagnosis and treatment in 26 pulmonary infection patients after renal transplantation

Objectives: To analyze the strategies of the diagnosis and treatment in patients with the pulmonary infection after renal transplantation. Methods: A retrospective analysis was made on 28 cases of pulmonary infections among 285 patients undergoing renal transplantation. Results: The morbidity of pulmonary infection was 9.82%(28/285). The majority pathogens of pulmonary infection in this study were pseudomonas, staphylococcus epidermidis, canadida and cytomegalovirus. Chest X ray was important in the diagnosis, but there was no specificity to determine the pathogens. The mortality in 28 pulmonary infection patients was 32.1%(9/28). Most of the patients suffered from pulmonary infection within 4 months after the operation, and the postoperative period from 2 months to 4 months was a high risk time window for death caused by pulmonary infections. Conclusions: The morbidity and mortality of pulmonary infections, especially severe pneumonia, in patients with renal transplantation, are higher than healthy people. Treatment following clinical epidemiology and strategy of microbiology play a very important role to reduce the mortality in those patients.