醫(yī)學(xué)論文范文:肝移植術(shù)后巨細(xì)胞病毒感染的診斷和治療
【摘要】 目的 分析肝移植術(shù)后受體巨細(xì)胞病毒(CMV)感染的診斷和治療。方法 回顧性分析我科2000年11月至2007年12月期間進(jìn)行的肝移植病例,依據(jù)易感因素、臨床癥狀、外周血中CMVPP65和(或)CMVIgM及胸片明確診斷,以更昔洛韋抗病毒治療。結(jié)果 共收集資料111例(剔除相關(guān)資料不完整者)。發(fā)現(xiàn)CMV感染5例,CMV感染發(fā)生率為4.5%;其中2例發(fā)生CMV肺炎,CMV肺炎發(fā)生率為1.8%(占CMV感染的40%),2例均好轉(zhuǎn);顒(dòng)性CMV感染3例,2例治愈,1例好轉(zhuǎn)。結(jié)論 CMVPP65檢測(cè)能夠?qū)MV感染患者做出早期診斷并且指導(dǎo)治療。更昔洛韋能夠有效治療CMV感染。
【關(guān)鍵詞】 肝移植;巨細(xì)胞病毒;診斷;治療
Diagnosis and treatment of cytomegalovirus pneumonitis
following liver transplantation
ZHANG Yong, L Yi, XIE Zhantao, WAN Zhen, HU Liangshuo,YU Liang, LIU Chang, ZHANG Xufeng, MA Feng
Department of Hepatobiliary Surgery, the First Affiliated Hospital,Medical School of Xian Jiaotong University, Xian 710061, China
ABSTRACT: Objective To study the diagnosis and treatment of cytomegalovirus (CMV) infection after liver transplantation. Methods The clinical data of 111 patients who received liver transplantation from November 2000 to December 2007 in our hospital were analyzed retrospectively. The recipients were diagnosed as having CMV infection by the predisposing factors, clinical symptoms and detection of CMVPP65 and CMVIgM in peripheral blood specimens in combination with chest Xray. The treatment of CMV infection was administration of Ganciclovir. Results Five recipients were diagnosed as having CMV infection, with the incidence of 4.5%. Two were diagnosed as having CMV pneumonitis, with the incidence of 1.8% (40% of the recipients having CMV infection). Two were both improved. Three were diagnosed as having CMV active infection. Two of them were cured and one was improved. Conclusion The detection of CMVPP65 is necessary for early diagnosis and guiding treatment of CMV infection. Ganciclovir can exert significant therapeutic effects on CMV infection醫(yī).學(xué)全.在.線f1411.cn.
KEY WORDS: liver transplantation; cytomegalovirus; diagnosis; treatment
感染和排斥反應(yīng)是導(dǎo)致肝移植受體死亡和并發(fā)癥發(fā)生的最主要原因。巨細(xì)胞病毒(cytomegalovirus, CMV)感染是肝移植術(shù)后最常見(jiàn)的感染并發(fā)癥之一。本文回顧分析我院進(jìn)行的111例肝移植術(shù)后并發(fā)CMV感染的診斷和治療。