原位肝移植术后肺部感染8例临床分析

Analysis of 8 cases pulmonary infection after orthotopic liver transplantation

目的：探讨原位肝移植术后肺部感染的发病原因及防治措施。方法：分析我院2005年行原位肝移植手术患者中出现肺部感染的病例。结果：61例患者中出现肺部感染8例，发生率为13．11％；肺部感染发生时间均≤12d；致病菌中G^-杆菌多见为50％；感染患者中胸腔积液发病率75％，右侧为重。结论：肝移植术后4～5d为肺部感染的高发期；G^-为常见致病菌，对亚胺培南一西司他丁等药物敏感；胸腔积液多发但可不处理。应熟悉原位肝移植术后导致肺部感染的全身因素和局部因素并采取有效的预防措施；对于有感染迹象的病例可以在实验室检查结果回报前根据经验及时选用敏感抗生素。

Objective：To disscuss the cause of morbility and protective measures of the pulmonary infection after orthotopic liver transplantation. Methods：All the clinical data of 61 cases of liver transplantation were review in 2005 in our hospital. Result： There were 8 patients of 61 who caught pulmonary infection and the incidence was 13.11%. The time of pulmonary infection was ≤ 12 days after orthotopic liver transplantation. There were 50% G^- bacilus among the pathogenic bacteria. The incidence of pleural effussion was 75% and the right thoracic cavity was more serious. Conclusions： The 4th to 5th day is the high occurrence time of pulmonary infection after orthotopic liver transplantation. The G bacillus is common pathogenic bacteria and they are sensitive to Tienam. The pleural effusion is frequent and neednt to be dealed with. The general and local factors of pul- monary infection should be familiar with and taken effective precaution. Meanwhile, the cases with infection evidence should be dealed with sensitive antibiotics by experience before the reporting of laboratory examination.