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肾移植术后间质性肺炎治疗方法探讨

  • 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:探讨肾移植术后间质性肺炎发病情况及临床治疗

方法

方法:选择2011年12月-2015年12月进行肾移植的408例患者为研究对象,随机分为试验组及对照组,各204例。两组患者术后在院期间均予以静脉滴注更昔洛韦针剂。出院后,对照组口服更昔洛韦及复方新诺明,未予以特殊监测;试验组根据血药浓度和血肌酐水平,调整更昔洛韦及复方新诺明剂量。确诊间质性肺炎入院后,两组患者均联合应用更昔洛韦和复方新诺明抗原虫治疗,对照组适当进行糖皮质激素冲击治疗,未停用免疫抑制剂;试验组规律性应用大剂量糖皮质激素冲击,停用免疫抑制剂。比较其间质性肺炎发生率、手术至首次发病时间、治愈/好转率、病死率、发生排异反应率、平均住院时间等指标。

结果:试验组间质性肺炎发生率低于于对照组(21.57% vs 29.90%),治愈/好转率高于对照组(90.91% vs 82.25%),手术至首次发病时间小于对照组(86.00d vs 143.28d),以上差异均具有统计学意义(P<0.05),余指标未见统计学差异。

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 the diagnosis and treatment of interstitial pneumonia after renal transplantation.

Methods:408 kidney transplant recipients with interstitial pneumonia during the period from Dec,2011 to Dec, 2015 were enrolled and subdivided to control group(n=204) and test group(n=204). 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 groups received corticosteroid therapy and ganciclovir resistant cytomegalovirus( CMV) treatment, but the immunosuppressive drugs of the recipients in test group were reduced or withdrew and their dose of glucocorticoid was relatively bigger.Prophylaxis,the occurrence of interstitial pneumonia, onset time, cure / improvement rate, mortality, incidence of immune rejection and the average length of hospital stay were observed .

Results: The test group tends to have lower occurrence of interstitial pneumonia(21.57% vs 29.90%), higher cure rate(90.91% vs 82.25%) and later onset (86.00d vs 143.28d), and all above differences have significance(P<0.05).

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.肾移植术后间质性肺炎治疗方法探讨[J]. 国际精神病学杂志, , (): -

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