肾移植术后肺部感染的诊断与治疗

The clinical diagnosis and treatment in pulmonary infection after kidney transplantation

目的探讨肾移植术后肺部感染的诊断与治疗。方法对21例肾移植术后肺部感染的病原体及其致病特点、诊断、治疗等临床资料进行分析。结果21例肾移植术后肺部感染患者中单纯细菌感染6例(28.57%),真菌感染2例(9.52%),巨细胞病毒(CMV)感染2例(9.52%),结核菌感染1例(4.76%),混合感染9例(42.86%),病原体不清1例。2例予以呼吸机辅助治疗。19例治愈,治愈率为90.48%,2例直接死于肺部感染。结论肾移植术后肺部感染患者应早期行病原学诊断,积极有效抗感染,及时调整免疫抑制方案。

Objective To explore the diagnosis and treatment of pulmonary infection after kidney transplantation. Methods The pathogens and its pathogenesis characteristic, the clinical data such as diagnosis and treatment were retrospectively analyzed in 21 patients with the pulmonary infection following kidney transplantation. Results The pathogens of pulmonary infection were bacteria （6 cases） , fungi （2 cases） , cytomegalovirus （2 cases） , tubercle bacillus （ 1 case） , and bacteria mixed （9 cases） and there was no pathogen found in 1 patients. 2 cases were treatment by respirator. 19 patients were cured, 2 cases died. Conclusion Intensive care and active measures should be given to the pulmonary infection patients after kidney transplantation. The key points of successful treatment involves the etiology diagnosis, anti - infection, rectify immunosuppression project.