肾移植患者术后肺曲霉菌感染的CT表现临床分析与治疗研究  

Clinical analysis of CT manifestations and treatment of pulmonary Aspergillosis infections after renal transplantation

作　　者：李强[1] 黄涛[1] 高扬[2] 董震[1] 

机构地区：[1]青岛大学医学院附属医院肾脏移植科,山东青岛266003 [2]青岛大学医学院附属医院手术室,山东青岛266003

出　　处：《中华医院感染学杂志》2015年第12期2820-2821,2845,共3页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅重点扶持基金资助项目(SW-2010B029)

摘　　要：目的分析肾移植患者术后肺曲霉菌感染的不同CT表现特点,为合理选用抗菌药物治疗肺曲霉菌病提供依据。方法选取2011年1月-2013年12月进行肾移植手术后肺曲霉菌感染的42例患者为研究对象,随机分为两组,每组各21例,观察并分析两组患者的不同CT表现,对照组患者采用常规抗真菌感染治疗措施,试验组患者采用伏立康唑治疗,分别观察两组肾移植术后肺曲霉菌病患者的临床疗效进行统计分析。结果治疗前CT结果表现为结节、空气新月征、晕症分布率,对照组患者分别为80.95%、42.86%、33.33%,试验组分别为76.19%、52.38%、33.33%,两组患者的CT特征相同,主要以结节、空气新月征为主;治疗后对照组患者曲霉菌属感染半乳甘露聚糖阴性占66.67%、阳性占33.33%,试验组患者曲霉菌属感染半乳甘露聚糖阴性占90.48%、阳性占9.52%,两组比较差异有统计学意义(P<0.05);治疗后总有效率对照组为85.71%、试验组为95.23%,试验组总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论肾移植术后肺曲霉菌病患者的CT表现主要以结节、空气新月征和晕症等;使用伏立康唑抗真菌药物治疗肾移植术后肺曲霉菌病疗效确切,有效提高患者的治疗有效率。OBJECTIVE To analyze different CT manifestations of pulmonary Aspergillosis after renal transplantation so as to provide a basis for rational use of antimicrobial drugs for pulmonary Aspergillosis infections .METHODS Totally 42 patients with pulmonary Aspergillosis infections after renal transplantation during Jan .2011-Dec .2013 were enrolled and were randomly divided into two groups ,with 21 cases in each group .Different CT manifestations were observed and compared between the two groups . The control group received conventional antifungal infection treatment ,and the test group received voriconazole treatment . The clinical efficiency for pulmonary Aspergillosis infections after renal transplantation of the two groups were observed and statistically summarized .RESULTS The CT manifestations before treatment included nodules ,air crescent sign ,and halo ,the distribution rates of these manifestations were 80 .95% ,42 .86% ,33 .33% in the control group and were 76 .19% ,52 .38% ,33 .33% in the test group .After treatment ,galactomannan‐negative and galactomannan‐positive Aspergillus infected patients accounted for 66 .67% ,33 .33% in the control group and 90 .48% ,9 .52% in the test group ,the difference was significant （P〈0 .05） .After treatment ,the total efficiency was 85 .71% in the control group and 95 .23% in the test group ,indicating that the total efficiency in the test group was significantly higher than in the control group （ P〈 0 .05 ） .CONCLUSION CT manifestations of pulmonary Aspergillosis infections after renal transplantation mainly included nodules ,air crescent sign and halo . Voriconazole antifungal treatment for pulmonary Aspergillosis infections after kidney transplantation was effective which can significantly improve the efficacy .

关 键 词：肾移植术 肺曲霉菌 感染 CT特征 疗效对比 

分 类 号：R619.3[医药卫生—外科学]