20例原位肝移植术后真菌感染6例临床分析

目的：探讨原位肝移植术后真菌感染的诊断和治疗。方法：回顾性分析20例肝移植患者中术后6例真菌感染的种类、感染部位及药物治疗疗效。结果：20例肝移植患者中6例术后并发真菌感染7例次（1例患者发生2次感染），感染发生率为30％。发病中位时间为术后26d（3～101d）。其中，念珠菌6例次（86％），曲霉菌1例次（14％）。感染部位：肺部6例次（86％），泌尿系统1例次（14％）。大扶康治疗6例患者中，4例（67％）经顺利康复，2例（33％）死亡。结论：真菌感染是影响肝移植生存率的重要原因之一。早期诊断和及时治疗是治愈的关键。

Clinical analysis of 6 cases of fungal infection after orthotopic liver transplantation

Objective:To explore the diagnosis and treatment of fungal infection after orthotopic liver transplantation(OLT).Methods:The clinical data of 6 cases with fungal infection were analyzed in 20 cases after OLT,respectively.Results:Six patients(30%) developed invasive fungal infection.Median posttransplantation interval was 26 days(range 3 to 101).Lung fungal infection was found in 6 cases(86%),repeat infection in 1 case(14%) of them.Pathogens were Candida species(6 of 7,86%) and Aspergillus(1 of 7,14%).After treatment with fluconazole,4 patients were cured and 2 patients died.The mortality related to fungal infection was 33%.Conclusions:Fungal infection is one of important causes influencing survival rate after OLT.Early diagnosis and treatment is effective and safe to cure the disease.