肾移植术后肺部真菌感染65例的诊断和治疗

The diagnosis and treatment of fungal infections in lung after renal transplantation of 65 cases

目的 探讨肾移植术后肺部真菌感染的诊断和治疗。方法 分析 1 997年 1月～ 2 0 0 2年 6月肾移植术后 6 5例肺部真菌感染患者的临床资料。结果 6 5例真菌感染中 ,白色念珠菌 2 4例 ,克柔念珠菌 6例 ,平滑念珠菌 3例 ,曲霉菌 6例 ,毛霉菌 4例 ,新型隐球菌 2例 ,奴卡菌 3例 ,其中 2 1例有细菌、巨细胞病毒混合感染。 1 7例培养阴性。大扶康治愈 33例 ,两性霉素 B治愈 2 7例 ,死亡 5例。结论 肺部真菌感染是肾移植术后的严重并发症 ,死亡率高。

Objective To study the diagnosis and treatment of fungal infections in lung after renal transplantation.Methods To analyze 65 cases of fungal infections in lung after renal transplantation from January 1997 to June 2002. Results Among 65 cases, 24 were infected with candida albicans, 6 with mycormyccosis, 6 with aspergillum, 4 with mucor, 2 with cryptococcus neoformans and 3 with nocardia. 21 cases out of 65 cases were co infected with bacteria and (or) CMV. 17 cases were negative. 33 cases were cured with fluconazole, 27 with amphotericin B and 5 died.Conclusions Fungal infection in lung is a severe complication after renal transplantation and has a high mortality rate. Early diagnosis and treatment may achieve satisfactory effects in preventing fungal infection.