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目的:探讨原位肝移植术后肺部感染的发病原因及防治措施。方法:分析我院2005年行原位肝移植手术患者中出现肺部感染的病例。结果:61例患者中出现肺部感染8例,发生率为13.11%;肺部感染发生时间均≤12 d;致病菌中G-杆菌多见为50%;感染患者中胸腔积液发病率75%,右侧为重。结论:肝移植术后4~5 d为肺部感染的高发期;G-为常见致病菌,对亚胺培南-西司他丁等药物敏感;胸腔积液多发但可不处理。应熟悉原位肝移植术后导致肺部感染的全身因素和局部因素并采取有效的预防措施;对于有感染迹象的病例可以在实验室检查结果回报前根据经验及时选用敏感抗生素。
Objective: To investigate the etiology and prevention and treatment of pulmonary infection after orthotopic liver transplantation. Methods: In our hospital in 2005 underwent orthotopic liver transplantation patients with pulmonary infection cases. Results: Among the 61 patients, 8 cases of pulmonary infection occurred, the incidence rate was 13.11%; the time of pulmonary infection was ≤12 days; the incidence of G-bacilli was 50% in the pathogenic bacteria; the incidence of pleural effusion in the infected patients 75%, the right is heavy. CONCLUSION: The incidence of pulmonary infection is high at 4 ~ 5 days after liver transplantation. G- is a common pathogen that is sensitive to drugs such as imipenem-cilastatin. Pleural effusion may occur frequently but may not be treated. Should be familiar with the systemic and local factors leading to pulmonary infection after orthotopic liver transplantation and take effective preventive measures; for cases with signs of infection, sensitive antibiotics should be used according to experience before the return of laboratory results.