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间质性肺炎在肾移植术后发病情况分析及临床治疗方法探讨

  • 丁寿宁,熊烈,杨铁,杨爱桃

* 通信作者: 丁寿宁, 单位:益阳市中心医院肾移植科

摘要

[摘要]:
目的:探讨间质性肺炎在肾移植术后发病情况分析及临床治疗

方法

方法:选择XX医院,2011年12月-2015年12月进行肾移植的407例患者为研究对象,比较2011年12月-2013年12月与2014年1月-2015年12月,两个时期肾移植术后患者间质性肺炎发生率的差异、治疗异同以及预后。

结果:2011年12月-2013年12月期间190名患者接受肾移植手术,术后出现间质性肺炎61例,发生率为32.11%。该组患者早期术后在院期间予以静脉滴注更昔洛韦针剂,依据患者病情变化更改免疫抑制剂使用方案,出院后口服更昔洛韦及复方新诺明,确诊间质性肺炎后入院适当进行糖皮质激素冲击治疗,应用更昔洛韦和复方新诺明抗原虫治疗。52例患者痊愈或好转,7例患者死亡,2例放弃治疗,其中5例患者在治疗期间出现排异反应。2014年1月-2015年12月期间217名患者接受肾移植手术,术后出现间质性肺炎44例,发生率为20.28%。该组患者早期术后在院期间,予以静脉滴注更昔洛韦针剂,依据患者病情变化更改免疫抑制剂使用方案,出院后根据血药浓度和血肌酐水平,口服更昔洛韦及复方新诺明,确诊间质性肺炎入院后规律性应用大剂量糖皮质激素冲击,停用免疫抑制剂,联合应用更昔洛韦和复方新诺明抗原虫治疗。40例患者痊愈或好转,3例患者死亡,1例放弃治疗,其中4例患者在治疗期间出现排异反应。

结论:早期调整或停用免疫抑制剂,给予规律性较大剂量糖皮质激素冲击治疗有益于肾移植术后间质性肺炎患者。

关键词:[关键词]:间质性肺炎;肾移植手术;糖皮质激素

ABSTRACT

[Abstract]
Objective:To investigate diagnosis and treatment of interstitial pneumonia after renal transplantation.

Methods:96 kidney transplant recipients with interstitial pneumonia during the period from 2011 to 2015 in XX Hospital were enrolled in this study. The differences of prophylaxis,treatment and the occurrence of interstitial pneumonia were compared in two periods(2011.12-2013.12 vs 2014.2-2015.12).

Results:There were a total of 61 patients (32.11%) suffered Interstitial pneumonia after renal transplantation in this study and 44 patients(20.28%) in the later group vs 61 patients(32.11%) in the earlier one. All the patients received intravenous ganciclovir during the hospital stay and oral ganciclovir in the post-discharge period. After diagnosis of interstitial pneumonia, patients in both group got corticosteroid therapy and ganciclovir resistant cytomegalovirus( CMV) treatment, but the immunosuppressive drugs of the recipients during the period from January 2014 to December 2015 were reduced or withdrew. The later group tends to have higher cure rate(90.91% vs 82.25%) and lower mortality (6.82% vs 11.84%)

Conclusion  s:Early discontinuation of immunosuppressive agents and given corticosteroid therapy are beneficial for kidney transplant recipients with interstitial pneumonia.

Key words: [Key words]: Interstitial pneumonia;Renal transplantation ;Immunosuppressant ;

引用本文 / How to Cite This Article

丁寿宁,熊烈,杨铁,杨爱桃.间质性肺炎在肾移植术后发病情况分析及临床治疗方法探讨[J]. 国际精神病学杂志, , (): -

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