28例肾移植术后肺部感染患者的药物治疗分析

目的：分析肾移植术后肺部感染的抗感染与免疫抑制治疗方案。方法：统计28例肾移植术后因肺部感染入院治疗的患者的临床资料,对病原学检查、药敏试验结果、治疗方案和转归情况进行分析。结果：肾移植术后3个月内发生肺部感染的患者有9例（32.1%）,3～6个月发生感染有4例（14.3%）,1年以上发生感染有15例（53.6%）。混合感染6例（21.4%）,细菌感染11例（39.3%）,真菌感染3例（10.7%）,病毒感染4例（14.3%）,不明原因感染4例（14.3%）。根据肺部感染的不同程度,选择合适的抗感染治疗方案,同时调整免疫抑制剂方案。28例患者的住院时间为（19.4±16.3）d,2例治疗无效自动出院,2例死亡,其余治愈。结论：肾移植患者术后容易发生肺部感染,应根据病原学检查和药敏试验结果制定抗感染治疗方案。

Analysis of drug treatment of 28 patients with pulmonary infections after renal transplantation

Objective： To analyze the anti-infective and immunosuppressive treatment of pulmonary infections after renal transplantation. Methods： Clinical data of 28 patients with pulmonary infections after renal transplantation were collected. Results of etiological examinations and drug susceptibility tests, therapeutic regimens and prognosis of pulmonary diseases were retrospectively analyzed. Results： Nine patients（32.1%） occurred pulmonary infections within 3 months after renal transplanta- tion, 4 patients（14.3%） in 3-6 months after renal transplantation, and 15 patients（53.60%） in more than 1 year after renal transplantation. There were 6 cases （21.4%） of mixed infeetion,ll cases （39.3%） of bacterial infection,3 cases （10.7%） of fungal infection,4 cases （14.3%） of virus infection and 4 cases （14.3%） of unknown infection. Doctors made appropriate anti- microbial regimens according to severity of the infections and adjusted the immunosuppressive regimens. Hospitalization time of the 28 patients was （19.4±16.3） d. Two patients had no response to the therapy and then discharged voluntarily,2 patients died, while remaining patients recovered after therapy. Conclusion： Patients are susceptible to pulmonary infections after renal transplantation. Anti-infective regimens should be applied according to the results of etiological examinations and drug susceptibility tests.