老年肝移植患者术后早期细菌感染的特点及危险因素分析  

Early-stage bacterial infection following orthotopic liver transplantation in patients over 60 years old

作　　者：曾纪晓[1] 何晓顺[1] 朱晓峰[1] 黄洁夫[1] 

机构地区：[1]中山大学附属第一医院器官移植外科,广州510080

出　　处：《中华外科杂志》2008年第13期988-991,共4页Chinese Journal of Surgery

基　　金：广州市科技攻关计划基金资助项目（2005Z3-E0041）;China Medical Board in NewYork资助项目（06837）

摘　　要：目的探讨老年患者（≥60岁）肝移植术后早期细菌感染的特点和危险因素。方法回顾性总结69例老年肝移植患者的临床资料，分析其术后细菌感染发生率、部位、菌株、耐药性及易感因素。结果69例中38例（55．1％）术后发生细菌感染，30例（79．0％）为混合细菌感染；部位以多部位混合感染（68．4％）最为常见；感染导致死亡9例，占死亡人数的42．9％；致病菌前3位的为粪肠球菌、耐甲氧西林凝固酶阴性葡萄球菌、嗜麦芽寡单胞菌；术前营养状况不良、无肝期时间长、ICU停留时间长、术后机械辅助呼吸时间长是老年肝移植术后早期细菌感染的危险因素。结论老年肝移植术后细菌感染发生率高，主要菌株耐药性强；细菌感染是导致受者术后死亡的主要原因；针对相关的危险因素积极采取预防措施，有助于减少感染的发生。Objective To summarize the pathogenic characteristics of bacterial infection and analyze the risk factors after orthotopic liver transplantation （OLT） in patients over 60 years of age. Methods A retrospective study of 69 patients that were over 60 years of age and underwent OLT was carried out. Descriptive statistics and risk factor analysis were performed with SPSS 11. 0. Results Thirty-eight patients developed bacterial infection （55. 1% ） after OLT, and thirty recipients suffered from mixed bacterial infection（79.0%）. Multi-location infection was most commonly seen（68.4% ）. Nine patients died of bacterial infection. The primary pathogenic germs included enterococcus, meticillin-resistant coagulase negative staphylococcus, stenotronhomonas maltophilia. The risk factors related to bacterial infection included preoperative paratrophia,long anhepatic phase,use of ventilator and duration of ICU stay. Conclusions The old patients that have undergone OLT are susceptible to bacterial infection. Bacterial infections are associated with high rate of mortality and multidrug resistance. Eliminating various risk factors can reduce the incidence of bacterial infection.

关 键 词：肝移植 老年人 感染 危险因素 

分 类 号：R686[医药卫生—骨科学]