肝脏移植术后侵袭性真菌感染的临床特点分析

The clinical characteristics of invasive fungal infections after liver transplantation

目的分析肝脏移植术后侵袭性真菌感染的特点,以期寻求正确的方法降低真菌感染率,提高肝脏移植手术的治疗效果。方法以2010年-2012年112例肝脏移植手术患者作为研究对象,分析真菌感染患者的感染分布、真菌种类、时间分布以及对部分药物的耐药性,研究肝脏移植术后侵袭性真菌感染特点,所有数据均采用SPSS17.0进行统计分析。结果 112例肝脏移植手术患者共有21例确诊为真菌感染,感染率为18.8%;真菌检出率以白色假丝酵母菌为主,共21株占55.3%;感染部位以呼吸道为主,共26例次占68.4%;经过药敏试验发现,氟康唑、伊曲康唑、伏立康唑的耐药率极高,分别为66.5%、81.8%、79.5%。结论加强对高危患者在术后早期呼吸道、胃肠道等易感部位真菌感染的监测,力争早期发现真菌感染和及时治疗,根据真菌类型和药敏试验结果合理选择抗真菌类药物,有助于降低术后真菌感染发生率,提高手术成功率。

OBJECTIVE To investigate the clinical characteristics of invasive fungal infections after liver transplanta- tion, so as to find a correct way of decreasing fungal infections and improve the cure effect of liver transplantation. METHODS From 2010 to 2012, a total of 112 cases of liver transplant patients were treated as research subjects to analyze the distribution of infection fungal species distribution, distribution of infection time and drug resistance. Also the characteristics of invasive fungal after liver transplantation were studied. SPSS17.0 software was used for statistical analysis. RESULTS Among 112 cases of liver transplant patients, a total of 21 patients were diagnosed as fungal infections, with infection rate of 18. 8%; Candida albicans was the top one, with detection rate of 55.3% ; infection site was mainly at respiratory tract with 26 cases, accounting for 68.4%. After the drug sensi- tive test, fluconazole, itraconazole and voriconazole had high resistant rate, which were 66. 5%, 81. 8% and 79.5 %. CONCLUSION Strengthening the monitoring of respiratory tract, gastrointestinal tract and other parts of high-risk patients in the early postoperative, and st.riving to early detection and timely treatment of fungal infec- tions are necessary. According to the fungi type and drug susceptibility test results to reasonably choose antifungal drugs could help reduce postoperative fungal the incidence of infection and improve the success rate of surgery.