醫(yī)學(xué)論文范文:肝移植患者術(shù)后細(xì)菌感染的臨床分析

醫(yī)學(xué)論文范文:肝移植患者術(shù)后細(xì)菌感染的臨床分析

【摘要】 目的 探討肝移植患者術(shù)后細(xì)菌感染的發(fā)生情況及相關(guān)因素。方法 回顧性分析我院2005年1月～2007年10月期間的肝移植術(shù)后患者56例次的臨床資料，討論細(xì)菌感染的發(fā)生情況，并對(duì)可能導(dǎo)致術(shù)后細(xì)菌感染的相關(guān)因素進(jìn)行分析，篩選臨床危險(xiǎn)因素。結(jié)果 本組56例患者中29例(51.8%)發(fā)生細(xì)菌感染，感染部位以肺部(53.7%)為主，感染的菌種中G+菌(46.3%)主要為金葡菌及腸球菌，G-菌(53.7%)分布較分散。單因素及多因素logistic回歸顯示手術(shù)時(shí)間超過10h及呼吸機(jī)使用時(shí)間超過24h為手術(shù)后細(xì)菌感染的危險(xiǎn)因素。結(jié)論 細(xì)菌感染是肝移植術(shù)后常見的并發(fā)癥，臨床應(yīng)針對(duì)其可能的危險(xiǎn)因素，采取提高手術(shù)技巧，促進(jìn)呼吸功能恢復(fù)等手段，以減少術(shù)后細(xì)菌感染的發(fā)生。

【關(guān)鍵詞】 肝移植;細(xì)菌感染;危險(xiǎn)因素

Clinical analysis of bacterial infection in liver transplant recipients

GAO Rui, L�a Yi, LIU Chang, XIE Zhan�瞭ao, ZHAI Chao, SHI Jian�瞙ua, WAN Zhen

1. Department of Hepatobiliary Surgery, the First Affiliated Hospital,Medical School of Xi�餫n Jiaotong University; 2. Faculty of Nursing,Medical School of Xi�餫n Jiaotong University, Xi�餫n 710061, China

ABSTRACT: Objective To explore the incidence and risk factors of bacterial infection after othtotopic liver transplantation (OLT). Methods Altogether 56 OLT recipients from January 2005 to October 2007 were included in the study. The incidents and the related variables of the infection were analyzed retrospectively. The related variables were evaluated using multivariate logistic regression model to identify the significant risk factors. Results Bacterial infection was confirmed in 29 recipients (51.8%). Among them, the lung infection was the most common site (53.7%). The Gram�瞤ositive cocci were 46.3%, while the Gram�瞡egative bacilli were 53.7%. The risk factors for bacterial infection included duration of the operation and detained respirator using. Conclusion Bacterial infection is a major complication following OLT. Surveillance for the risk factors, enhancement the skill of operation, and improving the recovery of respiratory function is the key to decreasing the incidence of bacterial infection after transplantation.

KEY WORDS: liver transplantation; bacterial infection; risk factor醫(yī).學(xué)全.在.線m.gydjdsj.org.cn

肝移植手術(shù)已經(jīng)在治療終末期肝病方面取得了很大成功。但是，術(shù)后感染是肝移植術(shù)后常見的并發(fā)癥，往往影響手術(shù)的預(yù)后，其發(fā)生率高達(dá)37.9%～66%[1��2]，其中細(xì)菌感染約占所有病原體感染的2/3[2��3]。了解肝移植術(shù)后細(xì)菌感染的種類及分布特點(diǎn)，對(duì)于肝移植術(shù)后感染的預(yù)防和護(hù)理有重要作用。現(xiàn)將我院肝移植科2005年1月～2007年10月施行的56例肝移植患者術(shù)后院內(nèi)細(xì)菌感染情況和分離的所有菌株進(jìn)行回顧性分析，以初步探討術(shù)后細(xì)菌感染的相關(guān)危險(xiǎn)因素。

1 資料與方法

1.1 一般資料

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