经验性治疗肝移植术后非结核分枝杆菌感染1例附文献复习.PDF

1 总结肝移植术后非结核分枝杆菌（NTM ）感染的诊疗经验。 对第二军医大学附属长征 医院收治的 1 例肝移植术后 NTM 成功经验性治疗病例进行研究分析，并对相关文献进行回顾。1 例肝移植 术后 7 个月 NTM 感染患者，临床表现以午后发热为主，动态 CT 检查提示病情进展时右肺下叶基底段内病灶扩 大融合且出现薄壁空洞。采用纤维支气管镜检查 （刷检或灌洗）、结核分枝杆菌感染 T 细胞免疫斑点试验 （T-SPOT. TB ）、多次痰培养及经验性抗结核治疗支持NTM 感染的诊断。该患者诊断性四联抗结核治疗有效，治愈后出院。 随访持续至投稿日，患者病情平稳，无再次出现发热、咳喘症状，肝功能正常。肝移植术后 NTM 感染罕 见但不可忽视，纤维支气管镜刷检或灌洗可提高阳性发现率，诊断性四联抗结核治疗有效。 　肝移植；术后感染；非结核分枝杆菌；结核分枝杆菌感染 T 细胞免疫斑点试验 (T-SPOT.TB) ； 纤维支气管镜；抗酸染色；痰培养 R617 ，R378.91　 A　 1674-7445 （2017 ）03-0009-05 Empirical treatment of nontuberculosis mycobacterium infection after liver transplantation: one case report and literature review Mao Jiaxi, Zou You, Guo Wenyuan. Department of Liver Transplantation, Changzheng Hospital of Second Military Medical University, Shanghai 200003, China Corresponding author: Guo Wenyuan, Email: guowenyuan@ Abstract Objective 【 】 To summarize the clinical experience of diagnosis and treatment of nontuberculosis mycobacterium (NTM) infection after liver transplantation. Methods Clinical experience of effective treatment of 1 case with NTM at 7th month after liver transplantation at the Shanghai Changzheng Hospital affiliated to the Second Military Medical University was summarized and literature review was performed. Results Following liver transplantation, the NTM patient was clinically manifested with fever in the afternoon. CT scan prompted the progression of the disease. The lesions were enlarged and fused with thin-walled cavity in the right upper lung. The dia