肝移植术后肺部真菌感染的诊断和治疗

目的探讨肝移植术后肺部真菌感染的早期诊断及治疗方法。方法回顾分析20例肝移植术后肺部真菌感染患者的临床资料，分析其原发病、免疫状态、感染真菌的种类及抗真菌药物的应用。结果20例患者念珠菌感染17例，死亡2例，曲霉菌感染3例，死亡2例。氟康唑、伊曲康唑、两性霉素B治疗有效率70％，伏立康唑、卡泊芬净治疗有效率100％。结论肝移植术后真菌感染高发，以危重患者为主要目标人群，发生早，病情重。诊断分三级，达到临床诊断即应及早治疗。治疗以伏立康唑为首选，严重感染者联合应用卡泊芬净效果良好。

Diagnosis and treatment of lung fungous infection after liver transplantation of liver

Objective To study the methods of diagnosis and treatment for lung fungous infection after liver transplantation.Methods Twenty cases of lung fungous infection were analyzed retrospectively,and the primary diseases,immune state,types of the infected fungi and the antimycotic drugs were estimated.Results Among 20 patients receiving liver transplantation,17 cases were suffered from Monilia infection and there were 2 deaths,and 3 cases from Aspergillus infection and there were 2 deaths.The effective rate of Fluconazol,Itraconazole and Amphotericin B was 70%.And that of Vorionazole and Caspofungin was 100%.Conclusion Fungous infection after liver transplantation was common and severe.Three degree standards of DG were accepted.The curative effect of Vorionazole and Caspofungin was better.