中国感染控制杂志2012，Vol.11Issue(2)：119-121,145,4.
肾移植术后肺部感染致急性呼吸窘迫综合征的特征与治疗
Treatment and characteristics of acute respiratory distress syndrome caused by pulmonary infection after renal transplantation
桂培根 1骆志清 1曾钧发 1言彩红 1李方 1黄治家 1杨吉军 1肖宏 1吴昆鹏1
作者信息
- 1. 南华大学附属第二医院,湖南衡阳412001
- 折叠
摘要
Abstract
Objective To evaluate the clinical characteristics and prevention and control measures of acute respiratory distress syndrome (ARES) caused by pulmonary infection(PI) after renal transplantation. Methods Clinical data of 40 patients with PI and respiratory failure after renal transplantation in an intensive care unit through Januar-y,2003 to January, 2011 were analyzed retrospectively. Results PI mostly occurred in renal transplant patients after 3-6 months of operation (32 cases, 80. 00%), the main clinical manifestation was fever, patients in serious condition could develop chest distress, dyspnea, decrease in blood oxygen saturation degree, and eventually ARDS Early chest radiograph only displayed increased pulmonary markings, blurred or dotted patch. The lung interstitial changes by CT scanning showed increased bilateral subpulmonary markings, reticular or ground glass shadows. Viruses and opportunistic fungi were major infection agents. 16 patients were survived and 24 died, the death rate was 60. 00%. Early death was mainly due to multiple organ dysfunction caused by severe systemic inflammatory response syndrome, and cause of death in advanced stage was respiratory failure caused by fungi or hospital-acquired resistant bacteria. Conclusion Mortality of ARDS caused by PI in renal transplantation patients is high. Early diagnosis, rational adjust or stop immunosuppressant application, empirical anti-infective therapy and application of glu-cocorticoid, noninvasive ventilation, rational nutritional support for reducing risk of aspiration, and application of laminar flow ward will gain time for patients' rehabilitatioa关键词
肾移植/肺炎/急性呼吸窘迫综合征/病原学/无创机械通气/肠内营养Key words
renal transplantations pulmonary infections acute respiratory distress syndromes etiology/ noninvasive ventilation/ enteral nutrition分类
医药卫生引用本文复制引用
桂培根,骆志清,曾钧发,言彩红,李方,黄治家,杨吉军,肖宏,吴昆鹏..肾移植术后肺部感染致急性呼吸窘迫综合征的特征与治疗[J].中国感染控制杂志,2012,11(2):119-121,145,4.
