肾移植术后肺部真菌感染的诊治

目的　探讨肾移植术后肺部真菌感染的诊断与治疗。　方法　回顾性分析 4 3例肾移植术后肺部真菌感染患者的临床资料。男 35例 ,女 8例 ,平均年龄 32岁。发病时间平均为术后 5 9d。　结果　 4 3例患者中 ,白色念珠菌 16例 ,克柔念珠菌 4例 ,近平滑念珠菌 2例 ,曲霉菌 4例 ,毛霉菌 3例 ,新型隐球菌 1例 ,奴卡菌 2例 ,其中 14例有细菌、巨细胞病毒混合感染。 11例培养阴性。氟康唑10 0mg/次 ,3次 /d ,连续 10d ,治愈 2 3例 ;两性霉素B脂质体 5 0mg/d ,连续 10d ,治愈 17例 ;死亡 3例。　结论　肺部真菌感染是肾移植术后的严重并发症 ,死亡率高。早期诊断与治疗效果良好。

Management of fungal infection of the lungs following renal transplantation

Objective To investigate the diagnosis and treatment of fungal infections of the lungs after renal transplantation. Methods A total of 43 cases (35 males and 8 females,mean age of 32 years) fungal infections of the lungs after renal transplantation from January 1999 to March 2002 were retrospectively analyzed.The mean time from post-operation to onset of the infection was 59 days. Results Among the 43 cases,16 were infected with candidiasis ,4 with candida Krusei ,2 with candida parapsilosis ,3 with mycormyccosis ,4 with aspergillosis ,1 with cryptococcosis neoformans and 2 with nocardiasis .14 cases out of 43 cases were coinfected with bacteria and CMV.The other 11 cases were negative for fungus-culturing test.23 cases were cured with fluconazole (100 mg,3 times per day for 10 days),17 with amphotericin B (50 mg,once a day for 10 days)and 3 died. Conclusions Fungal infection of the lungs is a severe complication after renal transplantation. Early diagnosis and timely treatment may achieve satisfactory effects.