期刊文献+

肾移植后败血症7例

Sepsis following renal transplantation in 7 cases
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摘要 背景:由于免疫抑制剂及广谱抗生素的使用,使肾移植术后合并败血症的病原菌多样复杂,病情严重,致死率高。因此加强肾移植术后合并败血症临床病原学特点的认识,及早合适的治疗是提高感染治愈率的关键。目的:分析肾移植后并发败血症的临床病原学特点与治疗情况。方法:收集佛山市第一人民医院肾内科2007-06/2010-06的376例肾移植患者移植后并发败血症7例的临床资料,分别对其易感因素、病原学特点、临床表现及治疗方案进行回顾性分析。结果与结论:7例患者均有寒颤、发热(体温38.5~42.0℃),烦燥、气促4例,尿路刺激症4例。血压低于90/60mm Hg(1mm Hg=0.133kPa)伴血肌酐增高4例。大肠埃希氏菌4例,表皮葡萄球菌1例,白色念珠菌1例,马尔尼菲青霉菌1例。5例细菌感染为院外感染,2例真菌感染者为院内感染。4例感染大肠埃希氏菌者合并尿路感染。4例低血压休克并急性肾功能衰竭。经抗感染治疗、减少免疫抑制药物用量及对症处理。6例痊愈,1例死亡。早期诊断,联合用药,减少免疫抑制剂的用量是提高感染治愈率的关键。 BACKGROUND:Due to the use of immunosuppressants and broad-spectrum antibiotic, the pathogenic bacteria of sepsis is diverse and complex, accompanying with severe illness and high death rate. Therefore, to enforce clinical etiology characteristics understanding of sepsis after renal transplantation and to perform appropriate treatment as soon as possibly are the key to improve infection cure rate. OBJECTIVE:To analyze the clinical etiology characteristics and therapy of sepsis following renal transplantation. METHODS:The clinical data of 7 cases of sepsis in 376 patients following renal transplantation were collected from the Department of Nephrology, the First people’s Hospital of Foshan from June 2007 to June 2010. Predisposing factor, etiology characteristics, clinical manifestation and treatment of sepsis were retrospectively analyzed, respectively. RESULTS AND CONCLUSION:There were 7 cases of shivering and fever (T38.5-40.2 ℃), 4 cases of fantod and breathlessness, and 4 cases of urinary irritation symptoms;4 cases of blood pressure less than 90/60 mm Hg (1 mm Hg=0.133 kPa) with increased serum creatinine, 4 cases of Escherichia, 1 case of Staphylococcus epidermidis, 1 case of Blastomyces albicans, 1 case of Penicillium marneffi;5 cases of bacterial infection was community infection, 2 cases of fungous infection was hospital oneset of infection;4 cases suffered from Escherichia combined with urinary tract infection, and 4 cases suffered from hypotension shock and acute renal failure. Six sepsis patients were cured and one died after giving anti-infective therapy, reducing the dosage of immunosuppressant and symptomatic treatment. Early diagnosis, drug combination, and reducing the dosage of immunosuppressant are the key to improving cure rate against infection.
出处 《中国组织工程研究与临床康复》 CAS CSCD 北大核心 2011年第18期3398-3400,共3页 Journal of Clinical Rehabilitative Tissue Engineering Research
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参考文献15

  • 1Wolfe RA,Ashby VB,Milford EL,et al.Comparison of mortality in all patients on dialysis,patients on dialysis awaiting transplantation,and recipients of a first cadaveric transplant.N Engl J Med.1999;341(23):1725-1730.
  • 2Foley RN,Parfrey PS.Cardiovascular disease and mortality in ESRD.J Nephrol.1998;11(5):239-245.
  • 3Hypolite IO,Bucci J,Hshieh P,et al.Acute coronary syndromes after renal transplantation in patients with end-stage renal disease resulting from diabetes.Am J Transplant.2002;2(3):274-281.
  • 4Borg AJ,Kumagai M.FK 506 and xenogeneic human anti-porcine cellular reactivity.Transplant Proc.1991;23(6):2972-2973.
  • 5Sia IG,Paya CV.Infectious complications following renal transplantation.Surg Clin North Am.1998;78(1):95-112.
  • 6Mendelson M.Fever in the immunocompromised host.Emerg Med Clin North Am.1998;16(4):761-779.
  • 7刘勇,杨亦荣,郑少玲,夏鹏,陈文伟,沈龙捷,吴存造,孙贤斌,徐自强,李澄棣.145例肾移植受者死亡原因分析[J].中华器官移植杂志,2004,25(4):235-236. 被引量:16
  • 8赵永斌,朱云松,胡卫列,聂海波,陈昊.肾移植术后早期死亡原因分析[J].临床泌尿外科杂志,2006,21(3):210-212. 被引量:3
  • 9Abbott KC,Oliver JD 3rd,Hypolite I,et al.Hospitalizations for bacterial septicemia after renal transplantation in the united states.Am J Nephrol.2001;21(2):120-127.
  • 10陈灏珠.实用内科学[M].11版.北京:人民卫生出版社,2004:1549-1550.

二级参考文献9

  • 1Claudio P, Margarita V, Bruno C, et al. Risk factors for late kidney allograft failure. Kidney Int, 2002, 62:1848-1854.
  • 2Richard J, Howard PR, Alan IR, et al. The changing causes of graft loss and death after kidney transplantation. Transplantation,2002, 73: 1923-1928.
  • 3Porazko T, Boratynka, Patrzalek D, et al. Cauls of death among cadaver kidney graft recipients between 1983 and 2000. Transplant Proc, 2002, 34: 2066-2067.
  • 4Surazee P, Gian S, Sandra M, et al. Time dependency of factors affecting renal allograft survival[J]. J Am Soc Nephrol, 2001, 11:565.
  • 5Gema F F, Rafael E,Emilio R,et al.The risk of cardiovascular disease associated with proteinuria in renal transplant patients [J]. Transplantation, 2002, 73 (8):1345.
  • 6Vento S, Cainelli F, Mirandola F,et al. Fulminant hepatitis on withdrawal of chemotherapy in carriers of hepatitis C[J]. Laneet,1996,347:92.
  • 7任吉忠,闵志廉,朱有华,齐隽,王立明,王亚伟,郑军华,周梅生,徐丹枫.肾移植患者合并严重肺部感染的临床诊断与救治(附45例报告)[J].肾脏病与透析肾移植杂志,2001,10(2):106-109. 被引量:56
  • 8肖序仁,敖建华,李炎唐,卢锦山,洪宝发.肾移植176例死亡分析[J].中华泌尿外科杂志,2003,24(3):183-187. 被引量:11
  • 9钱叶勇,石炳毅,蔡明,李州利,常京元,柏宏伟,王亚炜,王大庆.肾脏移植围手术期死亡病例原因分析[J].解放军医学杂志,2004,29(1):71-72. 被引量:1

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