23例肾移植术后肺部感染的抗生素治疗  

Antibiotics treatment in patients with pulmonary infection after renal transplantation

作　　者：李景勤[1] 

机构地区：[1]山东省青岛市中国人民解放军第401医院肾病中心,青岛266071

出　　处：《中国抗生素杂志》2012年第5期I0005-I0007,共3页Chinese Journal of Antibiotics

摘　　要：目的探讨肾移植术后肺部感染的临床特点、抗生素选择及使用方式。方法回顾性分析23例肾移植术后肺部感染的临床资料。结果 23例患者的肺部感染时间:术后3～6个月17例,术后7～15个月5例,术后6年9个月1例。发热是早期的主要症状,其他呼吸道症状轻微。病原体检查,以细菌感染为主,真菌次之,进展期常为混合感染,细菌对常用抗生素耐药率高。如治疗不及时或不正确,进展迅速。结论肾移植术后肺部感染是严重的并发症,其早期临床表现不典型,具有很高的死亡率。尽早确定诊断、明确病原体、选择敏感抗生素非常重要,未明确诊断前选用广谱强效抗生素治疗。抗生素降阶梯治疗方案(de-escalation therapy,DET)可提高治愈率。Objective To study the clinical character, antibiotic choice and use way in patients with pulmonary infection after renal transplantation. Methods To analyze retrospectively the clinical data of 23 patients with pulmonary infection after renal transplantation. Results The onset of pulmonary infection were during 3-6 months in 17 patients, 7-15 months in 5 patients,6 years and 9 months in one patient. Fever was the common, sometimes the only symptom.Other respiratory symptomes were light. If not diagnosed in time and treated correctly, the pulmonary infection would developed rapidly. Most of the patients were infected by bacterial and mycotic. Mixed infection may happen in the developed period.These bacterial were often resistant to the basic antibiotics. Conclusion The pulmonary infection is a severe complication for it＇s high mortality rate in the recipients of renal transplantation. The clinical manifestation was atypical. It is important to confirm the diagnose and pathogen early, choose effective antibiotics. Use potent and broad-spectrum antibiotic as soon as possible before the pathogen can be confirmed. Deescalation therapy of antibiotics can increase the cure rate.

关 键 词：肾移植 肺部感染 抗生素 

分 类 号：R617[医药卫生—外科学]