肝移植术后感染影响因素的临床研究进展  

The clinical research progress on the risk factors of postoperative infections for patients after liver transplantation

作　　者：卢建军[1] 刘大钺[1] 李恒爱[1] 熊莺[1] LU Jian-jun;LIU Da-yue;LI Heng-ai;XIONG Ying(The First Affiliated Hospital of Sun Yat-sen University,Guangzhou ,Guangdong510080,China)

机构地区：[1]中山大学附属第一医院医务处,广东广州510080

出　　处：《中华医院感染学杂志》2018年第24期3836-3840,共5页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金资助项目(A2015362)

摘　　要：肝脏移植是终末期肝脏疾病治疗的重要手段。由于手术技术、免疫状态、化学放射治疗、宿主与移植物之间的同种免疫机制以及病房环境等因素,肝脏移植患者术后容易出现医院感染。近年来,除了对既往文献报道的传统感染诱发因素有了进一步研究之外,研究者发现,还有一些新的危险因素应在今后被予以关注。这些因素可分为:与术前相关的因素,如终末期肝病评分(MELD)>30、移植前不合理抗菌药物使用史和机械通气等;与术中相关的危险因素,如失血量>10L;与术后相关的危险因素:如术后发生并发症;此外,还有与移植中心的手术开展情况有关因素:如每年进行少于50次移植手术。本文拟对近年来肝移植术后感染危险因素的文献进行综述,为肝移植术后感染相关危险因素防控措施的制定提供依据。Liver transplantation (LT)is an important therapy of end-stage liver disease.Due to surgical techniques,immune status,chemoradiotherapy,homologous immune mechanism between host and graft,ward environment and other factors,LT patients are prone to nosocomial infections.In recent years,researchers have found some new risk factors that should be paid attention to in future,in addition to traditional infection-inducing risk factors that have been previously reported.These factors include preoperative factors such as model for end-stage liver disease score >30,antibiotics abuse and mechanical ventilation,intraoperative factors such as blood loss of 10L,postoperative risk factors such as postoperative complications,and factors associated with the experience of transplant centers such as fewer than 50 transplantations a year.This paper aims to review the recent literatures on risk factors of infections after LT,and provide a basis for development of prevention and control measures for factors related to infections after LT.

关 键 词：肝移植 感染 危险因素 进展 临床研究 

分 类 号：R619.3[医药卫生—外科学]