肾移植术后肺部感染的调查与分析

Pulmonary Infection after Kidney Transplantation:Survey and Analysis

目的分析肾移植术后肺部感染尤其卡氏肺孢子虫性肺炎发生的特点,探讨有效控制措施,降低感染的发生。方法对2004年1-2月肾移植术后发生肺炎的患者进行前瞻性调查,对2003年1月-2004年12月所有肾移植术后患者进行回顾性调查,并比较卡氏肺孢子虫性肺炎与其他类型肺部感染的特点。结果2003年1月-2004年12月肾移植术后病例92例,发生肺部感染19例,感染率20.7%;其中卡氏肺孢子虫性肺炎8例,占42.1%;卡氏肺孢子虫性肺炎发生感染时间的中位数为术后61 d。结论肾移植术后感染以肺部感染为主,而在肺部感染的病例中,提示预防肾移植术后发生肺部感染,尤其是控制卡氏肺孢子虫性肺炎的发生,是降低肾移植术后感染的关键。

OBJECTIVE To analyze the characteristic of pulmonary infection especially for the Pneumocystis carinii pneumonia （PCP） after kidney transplantation and discuss the effective control measures to reduce the infection rate. METHODS The prospective investigation was conducted among in the kidney transplant patients with pneumonia between Jan and Feb in 2004. and the retrospective investigation was conducted among the cases with kidney transplant from Jan 2003 to Dec 2004 and the characteristic of PCP with other kinds of pneumonia was compared. RESULTS Ninety two cases with kidney transplant from Jan 2003 to Dec 2004 were investigated, of which 19 patients （20.7%） had pneumonia, 8 PCPs （42.1%） occurred. The median of PCP appearing time was 61days after the operation. CONCLUSIONS The pneumonia is the most familiar infection after the kidney transplantation. Prevention from the pneumonia after the kidney transplantation, especially PCP is the keystone to reduce the infection for the kidney transplantation.