肾移植术后感染诊治分析

Analysis of the Infection after Renal Tansplantation

目的探讨肾移植患者术后感染临床特点及诊治方法.方法对18例肾移植术后感染患者的临床资料进行回顾性分析.结果18例患者中,11例(61.2%)为尸体供肾肾移植患者,12例(66.7%)发生于术后3月内,15例(83.3%)发生于术后6月内.14例(77.8%)以发热为主要症状,呼吸道感染15例(83.3%),其中13例(72.2%)为肺部感染.3例(16.7%)死亡.结论肾移植患者感染多发生于术后半年内,尤其是术后3个月内,以肺部感染最为常见,且常常是混合性感染;病原体呈多样性,病原体检出率较低.治疗以综合治疗为主,及时调整免疫抑制剂治疗方案甚至停用免疫抑制剂.尸体供肾患者感染发生率较活体高;重症肺炎合并CMV感染可能提示预后不良;真菌感染在肺部感染患者中感染率较高.

Objective To investigate the clinical features and treatment measures of infection in kideney transplantation patients. Method The clinical data of 18 patients with infection following kidney transplantation were retropectively analyzed. Results Among 18 patients, 11 （61.2%）patients were deceased-donor renal transplant recipients. 12（66.7% ）patients occurred within 3 months, 15 （83.3%）patients occurred within 6 month - s. Among 14 （77.8%）patients, fever was the main symptom, 15 patients （83.3%） with respiratory tract infection, 13 （72.2%）patients were pulmonary infection, 3 （ 16.7% ）of them died. Conclusions Infection following kidney transplantation mainly occurs within 6 months, especially within 3 months. Lungs infection was the most common and the patiens always with mixed infections. Pathogens are various, and the detection rate is very low. Combined therapy is the main method, timely adjustment of immunosuppresive agents and even discontinuance them will be effective. Severe pneumonia with CMV infection may suggest unfavourable prognosis. The fungous infection rate in the patients with pulmonary infection is fairly high.