肝移植患者术后早期感染病原菌分析及护理对策  

Analysis of pathogenic bacteria and nursing strategies for patients with early infection after liver transplantation

作　　者：张玲[1] 胡少华[2] 赵红川[1] 方颖[1] 何莹[1] 耿小平[1] ZHANGLing;HU Shao-hua;ZHAO Hong-chuan(Department of hepatobiliry surgery,the first affiliated hospital of Anhui medical university,Hefei,Anhui 230022,China;Department of Nursing,the first affiliated hospital of Anhui medical university,Hefei,Anhui230022,China)

机构地区：[1]安徽医科大学第一附属医院肝胆外科,合肥230022 [2]安徽医科大学第一附属医院护理部,合肥230022

出　　处：《肝胆外科杂志》2019年第3期178-182,共5页Journal of Hepatobiliary Surgery

基　　金：安徽省自然科学基金项目(1508085MH160)

摘　　要：目的分析中国公民逝世后器官捐献(China donation after citizen's death,CDCD)供肝肝移植患者术后早期感染的病原菌种类及易感部位,探讨针对性护理策略。方法回顾性分析2016年3月至2019年1月期间在我院行成人CDCD供肝肝移植的28例患者临床资料。结果术后感染发生率92.86%,其中呼吸道感染发生率64.29%、尿道感染发生率53.57%、腹腔感染发生率46.43%、胆道感染发生率25%,消化道与血流感染发生率均为17.86%,呼吸道是肝移植术后早期最常见的感染部位。28例188例次标本培养显示存在感染检出病原菌,其中104例次标本培养结果为革兰氏阴性杆菌,占55.32%;37例次标本培养结果为革兰氏阳性球菌,占19.68%。47例次培养结果为真菌,占25%。革兰氏阴性杆菌是肝移植术后早期感染的主要病原菌。结论成人CDCD供肝肝移植术后早期感染发生率高,肺部感染高发的同时可存在多个部位感染;病原菌复杂,以革兰氏阴性杆菌为主,因此在全范围综合防治的同时,可针对易感部位及主要病原菌采取针对性护理干预措施,以降低感染发生率。Objective To analyze the type of pathogenic bacteria and nursing strategies of organ donation after liver transplan- tation for patients of China donation after citizen's death.Methods The clinical data of 28 patients who received CDCD for liver transplantation in the hospital from March 2016 to January 2019 were analyzed retrospectively.Results 92.86% of the patients were infected, including 64.29% of respiratory infections,53.57% of urethral infections,46.43% of abdominal cavity infection,25% of biliary tract infection,17.86% of gastrointestinal infections and blood flow infections,results show respiratory tract were the most common infection sites in the early stages after liver transplantation.188 cases of specimen culture showed positive pathogen from 28 patients,of which 104 specimen cultures were Gram-negative Bacillus,accounting for 55.32%,The culture results of 37 specimens were Grampositive Cocci,accounting for 19.68%.The results of 47 cultures were fungi,accounting for 25%.Gram-negative bacteria are the main pathogens of early infection after liver transplantation.Conclusions Adult CDCD patients with liver transplantation had a high incidence of infection in the early stage of operation,with high incidence of lung infection.The pathogenic bacteria are complex and mainly Gram-negative Bacillus.Therefore,at the same time as comprehensive prevention and treatment,targeted nursing interventions can be taken to reduce the incidence of infection.

关 键 词：中国公民逝世后器官捐献 供肝 肝移植 感染 护理 

分 类 号：R575[医药卫生—消化系统]