肾移植后重症肺炎的诊断与治疗(附18例报告)

目的　探讨肾移植后重症肺炎的发病特点及救治措施。方法　对 18例肾移植后发生重症肺炎患者的临床资料进行回顾性分析。结果　 12例 (68% )重症肺部感染患者救治获得成功 ,死亡 6例。结论　对于肾移植后的重症肺炎应及时大幅度调整免疫抑制药物用量 ,采用降阶梯策略选用抗生素、针对多种病原体综合治疗 ,积极呼吸支持、营养支持综合处理是救治成功的关键。

THE DIAGNOSIS AND TREATMENT OF SEVERE PNEUMONIA IN KIDNEY TRANSPLANT RECIPIENTS

Objectives To explore the features and treatment measures o f severe pneumonia in kidney transplant recipients. Methods A retrospective analysis was made on 18 patients with severe pneumonia following kidney transplantation. Result 12 of 18 patients recovered,wh ile 5 died, the rest one gave up the management and died. The mortality rate was 32%(6 of 18). Conclusions A combination of early detection o f the responsible pathogen, aggressive reduction of the immunosuppressive therap y, the immediate empirical de-escalation therapy is an effective strategy to tr eat severe pneumonia kidney transplantation (KTX)recipients.