2 5 例肝移植术后肺部感染临床分析.pdfVIP

6·24 · Chin J Nosocomiol Vol. 14 No. 6 2004 ·论 　著· 25 例肝移植术后肺部感染临床分析 王槐志 , 董家鸿 , 卢 　倩 , 闫 　军 , 陈 　耿 , 张 　霁 (第三军医大学西南医院全军肝胆外科研究所 解放军西南肝胆外科医院 , 重庆 400038) 摘要 : 目的 　分析我院肝移植术后肺部感染的高危因素 , 探讨其防治策略。方法 　回顾分析我院25 例肝移植术 后肺部感染的临床资料。结果 　18 例术后发生肺部感染 , 感染率为 72 % ;11 例肺部感染的病原体为细菌 , 其中 8 例为耐药的 G- 菌 ,术后使用呼吸机 ≥2 d 、长时间手术等因素为肺部感染的高危因素。结论 　术后第 1 周是肺 部感染的高危时段 ; G- 菌是常见的病原体 ;10 个因素为肺部感染的高危因素 ;术后肺部感染的预防应贯穿于整 个围手术期。 关键词 : 肝移植 ; 感染 ; 肺部 中图分类号: R619 + 3 　　文献标识码 : A 　　文章编号 : (2004) Pulmonary Infection after Orthotopic Liver Transplantation : 25 Case Clinical Analysis WAN G Huaizhi , DON G Jiahong , L U Qian , YAN J un , CHEN Geng , ZHAN G Ji ( Hepatobiliary S urgery Instit ute of PL A , Southwest Hospital Af f iliated to the Thi rd M ilitary Medical U niversity , Chong qing 400038 , China) Abstract : OBJECTIVE To analyze the risk factors of pulmonary infection after orthotopic liver transplantation and improve treatment strategy. METHODS The clinical data of 25 cases of liver transplantation were analyzed retrospectively from Jan 1999 to Apr 2001. RESULTS Pulmonary infection was found in 18 cases , the infection rate was 72 %. The pathogens of pulmonary infection in 11 cases were bacteria , 8 of them were antibioticresistant Gram negative bacteria. Mechanical ventilation ≥2 days and long operation time were risk factors of pulmonary infection. CONCL USIONS Danger stage of pulmonary infection is the first week after operation ; the main pathogens are Gram negative bacteria. There are 10 risk factors of pulmonary infection. Prophylaxis of pulmonary infection should be carried out during the whole pe