肝移植术后医院感染分析

Nosocomial Infections after Liver Transplantation: A Retrospective Study

目的 调查肝移植术后医院感染 ,探讨提高治愈率的措施。方法 回顾分析我院 1年来 5 2例肝移植患者 ,术后细菌感染及真菌感染情况。结果 5 2例肝移植中 11例并发细菌感染 (2 3 4 % ) ,真菌感染 3例 (6 4 % ) ,死亡4例 (8 5 % ) ,其中死于真菌感染 2例 ,肿瘤复发 1例 ,移植肝无功能 1例。结论 肝移植术后细菌感染发病率较高 ,但真菌感染是更危险的因素 ,由于真菌感染早期无快速特异性诊断方法 ,因此难以及时发现 ,预后较差 ,易感因素主要为机体抵抗力差 ,免疫抑制剂的使用及抗生素的不合理应用。

OBJECTIVE To explore the nosocomial infections in patients with liver transplantation, and to study the methods for increasing the cure rate. METHODS Fifty two cases were analyzed retrospectively from Apr 2002 to Feb 2003. The patients with bacterial and fungal infections were included. RESULTS Eleven cases complicated by bacterial infection (23.4%) and 3 cases with fungal infection (6.4%). The mortality was 8.5% (4 cases), including fungal infections (2 cases), recurrent tumor (1 case), and primary nonfunction (PNF) of graft. CONCLUSIONS Compared with bacterial infections, the fungal infections have worse prognosis because it is difficult to diagnose earlier. The susceptible factors include hypoimmunity, using immunosuppressive drug and antibiotic abuse.