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目的 :分析总结肾移植患者合并严重肺部感染的病因和治疗效果。方法 :对本院 1990年 4月至 2 0 0 0年 4月收治的 4 1例严重肺部感染患者进行回顾性分析。感染发生在术后 1月内 9例 ,1～ 6月者 2 2例 ,超过 6月者 10例。结果 :病原学 37例痰培养至少有一种致病菌生长 ,2例结核感染 ,12例霉菌感染 ,10例诊断CMV感染 ,4例未检测出病微生物。多数患者均采用二种以上不同的抗菌素 ,结合抗霉菌药、抗病毒药物或磺胺等药物治疗 ,治愈 2 5例 (6 1例 ) ,死亡 16例 (39% )。结论 :肺部感染是肾移植术后常见和严重的合并症 ;致病微生物仍以细菌、霉菌和巨细胞病毒感染占绝大部分 ,主张有低氧血症表现时及早人工呼吸机辅助呼吸。移植后超过 1月发生肺部感染者 ,若肾功正常 ,应尽早、尽量减低免疫抑制的使用 ,以利于控制感染
Objective: To analyze and summarize the etiology and therapeutic effect of severe pulmonary infection in patients with renal transplantation. Methods: A total of 41 cases of severe pulmonary infection admitted to our hospital from April 1990 to April 2000 were retrospectively analyzed. Infection occurred in 1 month after operation in 9 cases, 1 to 6 months in 22 cases, more than in June were 10 cases. Results: There were at least one pathogen growth in sputum culture in 37 cases of etiology, 2 cases of tuberculosis infection, 12 cases of mold infection, 10 cases of CMV infection and 4 cases of pathogenic microorganisms. Most patients were treated with two or more different antibiotics, combined with anti-fungal drugs, antiviral drugs or sulfa drugs, cured 25 cases (61 cases), 16 patients died (39%). CONCLUSIONS: Pulmonary infection is a common and serious complication after renal transplantation. Pathogenic microorganisms still account for the vast majority of bacterial, mold and cytomegalovirus infection, advocating the early resuscitation of artificial respirator with hypoxemia. More than 1 month after transplantation in patients with pulmonary infection, if normal kidney function, should be as soon as possible to minimize the use of immunosuppression in order to facilitate the control of infection