成人间活体肝移植术后受体真菌感染的易感因素分析  

Risk Factors for Fungal Infection in Adult Recipients Following Living Donor Liver Transplantation

作　　者：覃莉[1] 罗羽鸥 罗艳丽[1] 

机构地区：[1]四川大学华西医院肝脏外科/肝移植中心,成都610041

出　　处：《华西医学》2016年第4期679-682,共4页West China Medical Journal

基　　金：国家重大科技专项课题(2012ZX10002-016;2012ZX10002-017)~~

摘　　要：目的探讨成人间活体肝移植术后受体真菌感染的特点与易感因素。方法回顾性分析2006年1月-2012年12月189例成人活体肝移植的临床资料。采用Cox回归分析受体术后真菌感染的易感因素。结果 189例受体中有12例患者术后真菌培养阳性。术后最常见的真菌病原体为白假丝酵母菌,最常见的感染部位为肺部。多因素分析显示术前低白蛋白[HR=0.792,95%CI(0.694,0.903),P=0.001]、术中大量输血[HR=4.322,95%CI(1.308,14.277),P=0.016]、术后重症监护病房(ICU)时间长[HR=3.399,95%CI(1.004,11.506),P=0.049]是活体肝移植术后真菌感染的易感因素。结论成人间活体肝移植术后真菌感染好发于肺部,与术前低白蛋白、术中大量输血、术后ICU时间住院时间长有关。Objective To analyze the risk factors associated with fungal infections in adult recipients after living donor liver transplantation（LDLT）.Methods Data of 189 recipients from January 2006 to December 2012 who received LDLT at our center were retrospectively analyzed.Cox regression analysis was used to analyze the risk factors for postoperative fungal infections.Results Postoperative fungal infection was found in 12 recipients.The most common infectious site was lung,whereas the most common fungal pathogen was Candida albicans.Multivariate analysis suggested preoperative low albumin level [HR=0.792,95%CI（0.694,0.903）,P=0.001],massive intraoperative red blood cell transfusion [HR=4.322,95%CI（1.308,14.277）,P=0.016] and longer postoperative intensive care unit（ICU） stay [HR=3.399,95%CI（1.004,11.506）,P=0.049] were the independent risk factors for postoperative fungal infections.Conclusions Lung is the most common fungal infection site after LDLT.Preoperative low albumin level,massive intraoperative red blood cell transfusion and longer postoperative ICU contribute to fungal infections at er LDLT.

关 键 词：活体肝移植 真菌感染 易感因素 

分 类 号：R657.3[医药卫生—外科学]