实体器官移植术后并发败血症96例临床分析

摘要

目的:探讨实体器官移植术后并发败血症的临床表现、病原体、综合治疗及结果.方法:回顾性分析96例实体器官移植术后并发败血症患者的临床资料、病原体构成和来源、综合处理手段及成败原因.结果:96例患者共发生134次败血症,患者平均年龄42.4岁.实体器官移植术后并发败血症病原体种类繁多,病原体耐药性强,临床表现无特异性,抗感染效果差.经减量或停用免疫抑制剂、抗感染等处理,57例存活,败血症相关病死率为40.6％.结论:果断停用实体器官移植术后并发败血症患者的免疫抑制剂,及早使用敏感抗生素,以及强有力营养及器官功能支持是救治成功的关键,预防感染发生尤为关键.%Objective: To evaluate clinical characteristics, pathogens, treatment regimens and outcomes in patients with bloodstream infections (BSIs) after solid organ transplantation.Methods: Clinical data of ninety six cases of BSI were analyzed retrospectively to identify the pathogens and the origin of infection, and to evaluate comprehensive treatment and the causes of success or failure.Results: All 96 patients underwent the comprehensive treatments, including suspending administration of immunosuppressants and starting administration of approprite antibiotics. The clinical characteristics of patients with BSIs after solid organ transplantation were atypical. The pathogens were various and seriously multi-drug resistant, which led to a high mortality. Among them 57 cases recovered, but the BSI-related mortality rate was 40.6%.Conclusion: Stopping the administration of immunosuppressants, reasonable use of antibiotics,nutritional support and protecting the function of organs as soon as possible were of the greatest importance among of the various treatment plan. Avoidance of all kinds of infection in the first place is most important.