机械通气治疗肾移植术后卡氏肺孢菌重症肺炎的疗效分析  

Evaluation of Mechanical Ventilation for Patients with Acute Respiratory Distress Syndrome Caused by Pneumocystis Carinii After Renal Transplantation

作　　者：赵国志[1] 刘阳[1] 赖永通[1] 陈志勇[1] 郭雪坤[1] 黄先恩[1] 林民专[1] 

机构地区：[1]广州医学院第三附属医院器官移植科,广东广州510150

出　　处：《武汉大学学报（医学版）》2012年第4期574-577,共4页Medical Journal of Wuhan University

基　　金：广东省自然科学基金资助项目(编号:10451015001004853)

摘　　要：目的:探讨机械通气在治疗肾移植术后卡氏肺孢菌肺炎(PCP)合并急性呼吸窘迫综合征(ARDS)中的价值。方法:9例肾移植术后PCP合并ARDS患者,在早期抗卡氏肺孢子虫治疗、调整免疫抑制方案等综合治疗措施的基础上,全部给予机械通气治疗,观察其疗效。结果:9例患者中7例有效,有效率为77.78%,2例死亡,死亡率为22.22%。9例患者治疗后2,12,24,48及72h的动脉血氧分压、氧合指数及呼吸频率较治疗前均有改善(均为P<0.05)。结论:机械通气可在短时间内纠正缺氧保证氧合,为治疗原发病赢得时间,在治疗肾移植术后PCP合并ARDS患者的治疗中具有重要的意义。Objective： To evaluate the clinical value of mechanical ventilation for patients with acute respiratory distress syndrome（ARDS） caused by pneumocystis carinii pneumonia（PCP） after renal transplantation.Methods： A total of 9 cases of ARDS caused by PCP after renal transplantation were studied retrospectively.Mechanical ventilation was applied in all the 9 patients on base of combined therapy,and clinical effect were observed.Results： Seven cases recovered and two cased died,and the death rate were 22.22%.The PaO2,PaO2/FiO2,and respiratory rate were improved in all patients after mechanical ventilation for 2,12,24,48,and 72 hours.Conclusion： The mechanical ventilation was important to treat patient with ARDS caused by PCP after kidney transplantation because it could correct hypoxemia quickly and ensure oxygen pressure in artery blood in order to win time to cure primary disease.

关 键 词：机械通气 肾移植术 卡氏肺孢胞菌肺炎 

分 类 号：R699.2[医药卫生—泌尿科学]