71例肾移植受者术后肺部感染的诊治体会

Management of 71 Pulmonary Infection after Kidney Transplantation

目的探讨肾移植术后肺部感染发病特点、诊治及预防措施。方法回顾性分析71例肾移植术后肺部感染患者临床资料。结果71例患者中肺部感染发生于肾移植术后〈4个月54例（76．06％），4-6个月12例（16．9％），〉6个月5例（7．04％）。临床表现均有发热，23例为固定时间发热，52例感胸闷，19例迅速进展出现急性呼吸紧迫综合征（ARDS），3例死亡。混合感染者36例，细菌感染16例，巨细胞病毒（HCMV）感染13例，结核感染2例，肺孢子虫感染1例，不明原因3例。结论肾移植后肺部感染多为细菌为主的混合感染，病情进展迅速而危重，早期就诊，针对病原体合理抗菌治疗，及时调整免疫治疗方案和加强综合治疗是治疗成功的关键。

Objective To study the diagnosis,treatment and preventive measures of the pulmonary in- fection in the patients after kidney transplantation. Methods The clinical data of 71 cases with pulmonary in- fection following kidney transplantation were analyzed retrospectively. Results In 76. 06% （54/71） of patients the pulmonary infection occurred during 1-4 months after renal transplantation, 4-6 months, 12 cases （ 16. 9% ）, 〉6 months,5 cases （7.04%）. Pathogen was mainly cytomegalovirus and bacteria. Conclusion U- sually, the pulmonary infection after kidney transplantation were mixed infection of bacterium, progresses quickly and severely, early see a doctor, early diagnosis, Rational antibiotic therapy for pathogens, Timely adjust immuno- suppression, providing combined therapy, are the key treatment strategies for a successful result.