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目的研究肺移植术后患者发生曲霉菌感染的发病率和发病过程,探讨早期预防、检测和治疗曲霉菌感染的经验。方法回顾性分析2003年1月—2007年5月进行的15例单肺或双肺移植患者的临床资料,总结肺移植术后患者发生曲霉菌感染的发病率和发病过程以及诊疗经验。结果15例肺移植患者中,有5例(33%)患者在肺移植术后发生曲霉菌感染,其中气道内曲霉菌寄生、孤立性曲霉菌性支气管炎和侵袭性曲霉菌性肺炎这三种类型的发生率分别为13%、6%和13%。多数患者在术后1年内确诊。结论肺移植患者术后早期较容易发生曲霉菌感染。肺移植患者术后进行早期诊断和早期治疗对防治肺曲霉菌感染有着积极的作用,但是术前和术后早期使用抗真菌药物进行预防的效果还不确切。
Objective To study the incidence and pathogenesis of Aspergillus infection in patients after lung transplantation and to explore the early prevention, detection and treatment of Aspergillus infection. Methods The clinical data of 15 patients with single lung or double lung transplantation from January 2003 to May 2007 were retrospectively analyzed. The incidence, course and diagnosis and treatment experience of aspergillus infection in patients after lung transplantation were summarized. Results Of 15 lung transplant recipients, 5 (33%) patients developed aspergillosis after lung transplantation, with three types of airway aspergillus parasitic, isolated aspergillus bronchitis and invasive aspergillosis pneumonia The incidence of types were 13%, 6% and 13% respectively. Most patients diagnosed within 1 year after surgery. Conclusion Aspergillosis is more likely to occur early after lung transplantation in patients. Lung transplant patients with early diagnosis and early treatment for prevention and treatment of pulmonary aspergillosis have a positive effect, but the preoperative and postoperative early use of antifungal agents to prevent the effect is not clear.