肝移植患者术后细菌感染的临床分析

Clinical analysis of bacterial infection in liver transplant recipients

目的探讨肝移植患者术后细菌感染的发生情况及相关因素。方法回顾性分析我院2005年1月～2007年10月期间的肝移植术后患者56例次的临床资料，讨论细菌感染的发生情况，并对可能导致术后细菌感染的相关因素进行分析，筛选临床危险因素。结果本组56例患者中29例（51．8％）发生细菌感染，感染部位以肺部（53．7％）为主，感染的菌种中G^＋菌（46．3％）主要为金葡菌及肠球菌，G^-菌（53．7％）分布较分散。单因素及多因素logistic回归显示手术时间超过10h及呼吸机使用时间超过24h为手术后细菌感染的危险因素。结论细菌感染是肝移植术后常见的并发症，临床应针对其可能的危险因素，采取提高手术技巧，促进呼吸功能恢复等手段，以减少术后细菌感染的发生。

Objective To explore the incidence and risk factors of bacterial infection after othtotopic liver transplantation （OLT）. Methods Altogether 56 OLT recipients from January 2005 to October 2007 were included in the study. The incidents and the related variables of the infection were analyzed retrospectively. The related variables were evaluated using multivariate logistic regression model to identify the significant risk factors. Results Bacterial infection was confirmed in 29 recipients （51.8%）. Among them, the lung infection was the most common site （53.7%）. The Gram-positive cocci were 46.3%, while the Gram-negative bacilli were 53.7%. The risk factors for bacterial infection included duration of the operation and detained respirator using. Conclusion Bacterial infection is a major complication following OLT. Surveillance for the risk factors, enhancement the skill of operation, and improving the recovery of respiratory function is the key to decreasing the incidence of bacterial infection after transplantation.