肝脏移植术后肺部感染的防治  

Prevention and Treatment of Pulmonary Infection after Liver Transplantation

作　　者：徐志丹[1] 时军[1] 罗文峰[1] 王永刚[1] 罗来邦[1] 李新长[1] 龙成美[1] 

机构地区：[1]江西省人民医院器官移植科,南昌330006

出　　处：《实用临床医学（江西）》2010年第5期28-31,共4页Practical Clinical Medicine

基　　金：江西省科委课题

摘　　要：目的探讨肝脏移植术后肺部感染的原因及防治策略。方法回顾性分析江西省人民医院2000年1月至2008年12月收治的54例肝移植受者肺部感染的发生率、病死率、易感因素及防治措施。结果54例肝移植受者中6例发生肺部感染,感染率11.11%(6/54);死亡1例,病死率1.85%(1/54)。移植前后有多种因素与术后肺部感染有关。结论肝移植术后肺部感染率、病死率较高,早诊断、早治疗、及时"个体化"调整免疫抑制剂、控制液体入量、术后尽快拔除气管插管、保护肾功能、加强营养、提高病原检测技术及合理使用治疗药物等是防治肝移植术后肺部感染的关键。围手术期多方面因素均可能成为肺部感染的诱因,其防治工作必须贯穿整个围手术期。Objective To analyze the causes of pulmonary infection after liver transplantation and improve treatment strategy.Methods The clinical data of 54 patients undergoing liver transplantation in our hospital from Jan.2000 to Dec.2008 were studied retrospectively in order to analyze severe pulmonary infection incidence,fatality rate and susceptible factors as well as treatment strategy.Results There were 6 of 54 patients who caught pulmonary infection and the incidence was 11.11%（6/54）.The mortality rate in the patients who developed pulmonary infection was 1.85%（1/54）.Pulmonary infection could be caused by a variety of factors before or after operation.Conclusion The incidence and mortality of pulmonary infection after liver transplantation are high.The key for prevention and cure of pulmonary infection after liver transplantation should include of diagnosing timely,treating early,adjusting immunosuppressant according to the condition of patient in time,controlling intraoperative fluid perfusion,extubating as soon as possible,preventing renal dysfunction,improving nutrition,raising positive rate of pathogeny examination and using therapeutic drugs rationally.Many perioperative factors may be the inducers of pulmonary infections,so the prevention should be performed during all peritransplantation.

关 键 词：肝移植 肺部感染 预防 治疗 

分 类 号：R657.3[医药卫生—外科学]