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肾移植术后肺部感染的诱因分析及对策

Analysis and countermeasures of the cause of lung infection following renal transplantation

摘要:

目的 探讨肾移植术后肺部感染的常见诱因,并通过有针对性的预防措施减少肺部感染发生率.方法 回顾性分析2006年1月至2011年2月期间561例肾移植受者的临床资料,将受者分为两组.Ⅰ组:2006年1月至2009年12月接受肾移植,416例;Ⅱ组:2010年1月至2011年2月接受肾移植,145例.对Ⅰ组并发感染者在出现临床症状前3d内的可能导致呼吸道感染的诱因进行询问和记录,然后汇总分析.根据分析结果,制定一系列有针对性的、综合性的感染预防措施,Ⅱ组受者自2010年1月开始采用该措施,在应用14个月后对肺部感染发生率进行统计分析,并与Ⅰ组比较,观察预防效果.结果 Ⅰ组有58例受者出院后并发肺部感染,感染发生率为13.9%(58/416);Ⅱ组有12例并发肺部感染,感染发生率为8.3%(12/145),两组间肺部感染发生率的比较,差异有统计学意义(x2 =4.0361,P<0.05).两组肺部感染的发生时间均在术后6个月内.Ⅰ组58例肺部感染患者的诱因包括过度劳累6例,访客3例,出入公共场所9例,接触动物5例,接触儿童6例,天气骤变12例,以及医院内感染8例,其余9例诱因不明.结论 通过对肺部感染的具体诱因人手进行分析,并采取有针对性的具体的卫生宣教和预防措施,可显著减少肾移植术后肺部感染的发生率.

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abstracts:

Objective To analyze the common causes leading to lung infection following renal transplantation and provide targeted preventive measures to reduce the incidence of lung infection.Methods The clinical data of 561 recipients who underwent renal transplantation from January 2006 to February 2011 were retrospectively analyzed.The recipients were divided into two groups:group Ⅰ,from January 2006 to December 2009 (n =416) ; group Ⅱ,from January 2010 to February 2011 (n =145).The causes possibly leading to lung infection which took place 3 days before the appearance of the clinical symptoms were offered by the patients who suffered lung infection of group Ⅰ.And then the causes were summarized and analyzed to formulate the specific and comprehensive measures to prevent the infection.Finally the measures were applied to recipients in group Ⅱ from January 2010.After applying the measures for 14 months,the incidence of lung infection in group Ⅱ was counted and compared with that in group Ⅰ to see the preventive effect.Results There were 58 cases of lung infection in group Ⅰ (58/416,13.9%) and 12 cases in group Ⅱ (12/145,8.3%). There was significant difference in the incidence of lung infection between two groups (x2 =4.0361,P<0.05).All of the recipients with lung infection were hospitalized in six months after the transplantation.The causes leading to lung infection of 58 cases in group Ⅰ were as follows:6 cases due to being excessively tired,3 cases due to guest visiting,12 cases due to abrupt change of weather,9 cases due to exposure to public place,8 cases due to returning to hospital,6 cases due to close contact with children,5 cases due to close contact with animals,and the other 9 cases without specific causes found.Conclusion The incidence of lung infection following renal transplantation can be notably reduced by the application of targeted and concrete health propaganda education and preventive measures based on analysis on the specific causes of infection.

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作者: 李壮江 [1] 孙煦勇 [1] 聂峰 [1] 苏庆东 [1] 王慧英 [1] 罗海凤 [1] 周洁惠 [1]
分类号: R617
栏目名称: 临床研究
DOI: 10.3760/cma.j.issn.0254-1785.2012.04.009
发布时间: 2012-07-13
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