肾移植受者肺部侵袭性真菌感染的诊治经验

Diagnosis and treatment of invasive pulmonary fungal infection after kidney transplantation

目的总结肾移植后肺部侵袭性真菌感染的诊断和治疗经验。方法回顾分析昆明医科大学第一附属医院2012年1月-2015年12月期间诊治的36例肾移植术后侵袭性真菌感染患者的临床资料。结果 26例患者感染发生在术后6月之内,10例患者发生在术后6月以上,并发上消化道出血1例,死亡1例,使用呼吸机辅助呼吸2例,调整或停用免疫抑制剂,采用综合治疗方案,其中治愈35例患者。结论肾移植术后肺部侵袭性真菌感染多发生在术后6月内,需采用综合治疗方案,联合使用抗真菌药物,及时调整免疫抑制方案,加强全身支持治疗等是救治成功的关键。

Objective To summarize the diagnosis and treatment of invasive pulmonary fungal after kidney transplantation.Methods During January 2012 and December 2015,36 patients with IPFI were collected from the 1st Affiliated Hospital of Kunming Medical University.Resul26 patien infection （IPFI） post-transplant ts suffered from IPFI in 6 months after kidney transplantation, lO cases of which occurred beyond six months.Among the 36 patients,1 patient died,1 patient occurred upper gastrointeseinal bleeding,and 2 patients dischanged after treatment with mechanical ventilation.Total patients were taken of comprehensive treatment ,the immunosuppressant dose was reduced or stopped. There were 35 patients cured. Conclusion IPF! after kidney transplantation always occurs in the first 6 months after operations, combined with antifungal systemic support are the keys for healing drugs,prompt adjustment of immunosuppression regimen and