甲泼尼龙治疗肾移植患者术后重症肺部感染疗效分析  

Effect of methylprednisolone on treatment of severe postoperative pulmonary infections in renal transplantation patients

作　　者：孟凡航[1] 黄间开 郭雪坤[1] 陈志勇[1] 赖永通[1] 黄先恩[1] 林民专[1] 

机构地区：[1]广州医科大学附属第三医院器官移植科,广东广州510150

出　　处：《中华医院感染学杂志》2015年第8期1854-1856,共3页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金资助项目(A2010525)

摘　　要：目的探讨甲泼尼龙治疗肾移植患者术后重症肺部感染的效果,为治疗肾移植术后重症肺部感染提供参考。方法收集医院2012年1月-2014年1月收治的20例行肾移植术后重症肺部感染患者临床资料,根据患者肺部CT表现及发病特点使用治疗细菌、病毒、卡氏肺囊虫或真菌的综合方案进行,得到病原菌及病毒检测结果后进行治疗,根据患者病情调整或停用免疫抑制剂;将患者随机分为观察组和对照组,每组10例,观察组采用注射用甲泼尼龙辅助治疗,对照组延续口服醋酸泼尼松进行辅助治疗。结果观察组体温恢复正常时间为(3.2±1.3)d、动脉血气恢复正常时间为(9.5±2.1)d、肌酐为(97.5±14.5)μmol/L,对照组分别为(15.3±3.8)d、(16.8±3.6)d、(119.6±21.2)μmol/L,两组患者各项指标比较差异有统计学意义(P<0.05);两组患者均未出现不良反应。结论甲泼尼龙可有效改善肾移植术后重症肺部感染的临床症状,值得临床推广使用。OBJECTIVE To observe the effect of methylprednisolone on treatment of severe postoperative pulmonary infections in the renal transplantation patients so as to provide guidance for treatment of the severe postoperative pulmonary infections.METHODS The clinical data were collected from 20 patients who underwent the renal transplantation from Jan 2012 to Jan 2014 and were complicated with severe postoperative pulmonary infections,then the antimicrobial treatment was carried out by using the integrated program of bacteria,viruses,pneumocystis carinii,and fungi,the treatment was performed based on the results of detection of pathogens and viruses,and the immunosuppressants were adjusted or withdrawn according to the illness condition of the patients.The patients were randomly divided into the observation group and the control group,with 10 cases in each;the observation group was given the injection of methylprednisolone for adjuvant treatment,while the control group maintained the oral administration of prednisone for adjuvant treatment.RESULTS The time of body temperature returning to normal was（3.2±1.3）days in the observation group,（15.3±3.8）days in the control group;the time of arterial blood gas returning to normal was（9.5±2.1）days in the observation group,（16.8±3.6）days in the control group;the level of creatinine of the observation group was（97.5±14.5）μmol/L,the control group（119.6±21.2）μmol/L,and there was statistically significant difference in the above indicators between the two groups of patients（P〈0.05）.The adverse reactions occurred in neither of the two groups.CONCLUSION Methylprednisolone can effectively improve the clinical symptoms of the renal transplantation patients complicated with severe postoperative pulmonary infections,and it is worthy to be promoted in the hospital.

关 键 词：甲泼尼龙 肾移植术 重症肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]