原位肝移植术后近期感染分析
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Infection occurred with in short-term after orthotopic liver transplantation
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    摘要:

    目的:探讨原位肝移植术后1个月内感染的诊断、预防。方法: 回顾分析38例次原位肝移植的临床资料,对可能导致感染的危险因素进行分析。结果 : 全组18例患者出现29例次感染,感染率为47.4%(18/38)。所有感染均出现在术后3d以后,感染部位肺部占37.9%(11/29),腹腔24.1%(7/29),血液17.2%(5/29),胆道13.8%(4/29),泌尿系统3.4%(1/29),肝脏3.4%(1/29)。感染菌株中阴沟肠杆菌占27.6%(8/29),大肠埃希菌24.1%(7/29),金黄色葡萄球菌20.7%(6/29),表皮葡萄球菌10.3%(3/29),肺炎克雷伯菌6.9%(2/29),白色念株菌6.9%(2/29),粪肠球菌3.4%(1/29)。感染病死率38.9%(7/18)。上腹部手术史、手术持续时间、输血量、胆道重建方式、术后肠道功能恢复延迟、术后持续高血糖是感染的主要危险因素,围术期肠道去污治疗是预防感染的保护因素。结论 : 感染是影响肝移植生存率的重要因素之一,减少各种危险因素及围术期肠道去污治疗有助于降低感染的发生率。

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    To study the diagnosis and prophylaxis of postoperative infections within 1 month after orthotopic liver transplantation(OLT). Methods : Clinical date of 38 consecutive patients who underwent OLT at our institution from 2001 to 2003 were retrospectively reviewed. Result: Eighteen patients(47.4%) developed twenty-nine times infection after operation .Respiratory tract and peritoneum were the common infectious sites(37.9% and 24.1%). Enterobacter cloacae(8 of 29, 27.6%) , Escherichia coli(7 of 29, 24.1%),staphylococcus aureus(6 of 29, 20.7%) were the commonest bacterial.The mortality of infection was 38.9%(7/18). Identified risk factors for infection including: previous transplantation; duration of operation; transfusion requirements during surgery; type of biliary anastomosis; delayed restoration of gastrointestinal function and persistent postoperative hyperglucocemia . Perioperative decontamination of the digestive tract had a protective effect. Conclusions : Infections are a major cause of death among liver transplant recipients. Reducing risk factors of infection and perioperative decontamination of the digestive tract may decrease the occurrence of postoperative infection.

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成柯,黄祖发,朱晒红 ,张懋祖,叶启发,赵于军.原位肝移植术后近期感染分析[J].中国普通外科杂志,2004,13(3):17-219.
DOI:10.7659/j. issn.1005-6947.2004.03.017

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  • 在线发布日期: 2004-03-25