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The pathogens and effect analysis for patients with i ncurable fever in post-renal transplantation
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 4
- DOI:
- 10.3760/j.issn:1003-0603.2002.04.005
- Key Word:
- 发热;肾移植;病原菌
Abstract： 目的:探讨肾移植术后感染所致发热的临床和病原学特点与规律.方法:收集20例肾移植术后因难治性发热住入综合ICU患者的临床资料,分析发热时间、热型、临床症状、病原学检查结果.结果:肾移植术后1～6个月患者发热发生率最高(15例),高热(10例)与不规则发热(7例)居多.肺部感染发生率(24例)最高(革兰阴性杆菌15例,真菌7例,结核菌1例,巨细胞病毒1例),泌尿系感染(11例,其中真菌感染8例,革兰阴性杆菌3例)次之.革兰阴性杆菌与真菌性败血症也有发生(各3例),其中2例同时存在革兰阴性杆菌和真菌,单纯绿脓杆菌败血症1例.1例深静脉导管培养发现阴沟杆菌;1例有真菌性心肌炎伴脓肿形成和肺部白色念珠菌感染,尸检肺部检出巨细胞病毒合胞体;1例全身系统性(肺、泌尿系统、血液)真菌感染合并肺外结核感染.结论:肾移植术后感染所致发热最容易出现在术后1～6个月内;肺部细菌与真菌混合感染最多见,泌尿系统真菌感染次之,结核感染(肺内或肺外)也不能忽视 ,抗感染和抗真菌疗效不佳时应考虑到结核感染.
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