当前位置: 首页 > 医学版 > 期刊论文 > 内科学 > 中国危重病急救医学 > 2006年
编号:11258558
成人原位肝移植术后早期感染相关危险因素分析
http://www.100md.com 2006年10月17日 中国危重病急救医学2006;18(7):
关键词:摘要,目的,方法,结果,结论,关键词,Studyonriskfactorsforearlypostoperativeinfectionafterorthot

     王峪 刘懿禾 郑卫萍 明宇 沈中阳

    【摘要 目的 探讨成人原位肝移植术后早期(术后30 d内)感染相关危险因素。方法 采用回顾性对照研究方法,对400例成人原位肝移植术后患者进行感染相关危险因素的分析。结果 成人原位肝移植术后早期感染的发生率为30.3%(121/400例),常见细菌感染,占62.0%(75/121例);其次为真菌感染,占20.6%(25/121例),病毒感染,占12.4%(15/121例);其他占5.0%(6/121例)。常见感染部位依次为肺感染(63例,占52.1%)、胆道感染(23例,占19.0%)、腹腔感染(22例,占18.2%)、导管相关性脓毒症(13例,占10.7%)。Logistic回归分析发现,急性肾功能衰竭、早期移植肝功能恢复延迟、急性肺损伤、腹腔出血、肺水肿、既往糖尿病或术后新发生糖尿病、Child-Pugh评分>10分、年龄>60岁8项应视为成人原位肝移植术后早期感染的高危因素。结论 感染是成人原位肝移植术后早期临床常见的严重并发症,临床上可以通过积极的监测、合理应用抗生素和免疫抑制剂,认真处理急性肾功能衰竭及改善移植肝功能等手段减少感染的发生率。

    【关键词】 肝移植; 术后早期; 感染; 危险因素

    Study on risk factors for early postoperative infection after orthotopic liver transplantation in adults WANG Yu, LIU Yi-he, ZHENG Wei-ping, MING Yu, SHEN Zhong-yang. Department of Transplantation Surgery, The First Central Hospital of Tianjin, Tianjin 300192, China

    Corresponding author:SHEN Zhong-yang

    OBJECTIVE: To analyze risk factors related to infection during early postoperative peroid after orthotopic liver transplantation in adults. METHODS: Retrospective study of 400 cases of orthotopic liver transplantation in adults performed between 2003 and 2004. Pre, intra and postoperative variables of recipients were analyzed in two groups according to whether or not infection developed. RESULTS: Infection developed in 121 patients (30.3%). Bacterial infections were most common, accounting for 62.0% (75/121 cases), followed by fungal infection with the percentage of 20.6% (25/121 cases), and virus infection accounting for 12.4% (15/121 cases). The common infection sites were lung (63 cases, 52.1%), gullbladder (23 cases, 19.0%), peritoneal cavity (22 cases, 18.2%), and venous catheter (13 cases, 10.7%). Significant risk factors for infection as shown by the multivariate analysis were acute renal failure, graft dysfunction, acute lung injury, postoperative bleeding, pulmonary edema, history of diabetes mellitus or new onset diabetes mellitus, Child Pugh stage>10, age >60. CONCLUSION: Early postoperative infection after orthotopic liver transplantation in adults is a common and serious complication that continues to be difficult to control. Certain risk factors can be improved with careful management such as acute kidney failure and graft dysfunction. Appropriate antiinfection remedy is very important to prevent drug resistance. However, immunosuppression agents acts as a real predisposing factor of infection with regard to both its development and its clinical manifestation. ......

您现在查看是摘要页,全文长 8657 字符
如果您在使用手机等流览时无法查看或下载全文,可能是被搜索引擎失真“转码”,请点击屏幕最下方的“电脑版”或“原网页”访问。


限于服务器压力,网站部分信息只供爱心会员或有一定积分的注册会员流览。
此信息需要 2 积分(免费注册登录后每天可以领取10个积分)。
用户名
密 码
  忘了密码

如果您还不是100md.com会员,欢迎 免费注册
如果您想获得积分,点击这里 查看积分规则
    淇℃伅浠呬緵鍙傝€冿紝涓嶆瀯鎴愪换浣曚箣寤鸿銆佹帹鑽愭垨鎸囧紩銆傛枃绔犵増鏉冨睘浜庡師钁椾綔鏉冧汉锛岃嫢鎮ㄨ涓烘鏂囦笉瀹滆鏀跺綍渚涘ぇ瀹跺厤璐归槄璇伙紝璇烽偖浠舵垨鐢佃瘽閫氱煡鎴戜滑锛屾垜浠敹鍒伴€氱煡鍚庯紝浼氱珛鍗冲皢鎮ㄧ殑浣滃搧浠庢湰缃戠珯鍒犻櫎銆�

   寰俊鏂囩珷  鍏虫敞鐧炬媷  璇勮鍑犲彞  鎼滅储鏇村