器官移植
器官移植
기관이식
Organ Transplantation
2015年
6期
378-381
,共4页
易慧敏%魏绪霞%黎利娟%安玉玲%吕海金%易小猛%刘剑戎%熊亮%周密%陆平兰%郭煜
易慧敏%魏緒霞%黎利娟%安玉玲%呂海金%易小猛%劉劍戎%熊亮%週密%陸平蘭%郭煜
역혜민%위서하%려리연%안옥령%려해금%역소맹%류검융%웅량%주밀%륙평란%곽욱
肝移植%感染%脓毒症%抗感染%血液净化
肝移植%感染%膿毒癥%抗感染%血液淨化
간이식%감염%농독증%항감염%혈액정화
Liver transplantation%Infection%Sepsis%Anti-infection%Blood purification
目的：总结肝移植术后脓毒症的治疗经验。方法回顾性分析2014年9月中山大学附属第三医院外科重症监护室收治的1例肝移植术后脓毒症的临床特征及治疗方法，并复习国际严重脓毒症和脓毒症休克治疗指南（SSC 指南）解读及相关文献。结果1例50岁男性患者在肝移植术后1 d 出现高热、血压下降，诊断为感染性休克，经过适当的目标导向性液体复苏、抗感染、血液净化等治疗获得缓解，患者病情稳定出院。结论肝移植术后患者易发生感染，由感染引起的脓毒症病死率高，因此一旦发生脓毒症，临床医师要积极地按照 SSC 指南进行早期的目标导向性治疗及集束化治疗，根据病原培养结果选用合适的药物，降低病死率。
目的：總結肝移植術後膿毒癥的治療經驗。方法迴顧性分析2014年9月中山大學附屬第三醫院外科重癥鑑護室收治的1例肝移植術後膿毒癥的臨床特徵及治療方法，併複習國際嚴重膿毒癥和膿毒癥休剋治療指南（SSC 指南）解讀及相關文獻。結果1例50歲男性患者在肝移植術後1 d 齣現高熱、血壓下降，診斷為感染性休剋，經過適噹的目標導嚮性液體複囌、抗感染、血液淨化等治療穫得緩解，患者病情穩定齣院。結論肝移植術後患者易髮生感染，由感染引起的膿毒癥病死率高，因此一旦髮生膿毒癥，臨床醫師要積極地按照 SSC 指南進行早期的目標導嚮性治療及集束化治療，根據病原培養結果選用閤適的藥物，降低病死率。
목적：총결간이식술후농독증적치료경험。방법회고성분석2014년9월중산대학부속제삼의원외과중증감호실수치적1례간이식술후농독증적림상특정급치료방법，병복습국제엄중농독증화농독증휴극치료지남（SSC 지남）해독급상관문헌。결과1례50세남성환자재간이식술후1 d 출현고열、혈압하강，진단위감염성휴극，경과괄당적목표도향성액체복소、항감염、혈액정화등치료획득완해，환자병정은정출원。결론간이식술후환자역발생감염，유감염인기적농독증병사솔고，인차일단발생농독증，림상의사요적겁지안조 SSC 지남진행조기적목표도향성치료급집속화치료，근거병원배양결과선용합괄적약물，강저병사솔。
Objective To summarize the treatment experience of sepsis after liver transplantation.Methods The clinical features and treatment methods of 1 patient developing sepsis after liver transplantation, who was admitted and treated in the Surgical Intensive Care Unit of the Third Affiliated Hospital of Sun Yat-sen University in September 201 4,were retrospectively studied.The interpretation of International Guidelines for Management of Severe Sepsis and Septic Shock (SSC Guidelines)and relevant literature were reviewed.Results One male patient at the age of 50 years old developed high fever and decrease of blood pressure at 1 d after liver transplantation,and was diagnosed as septic shock.The symptoms were relieved after the appropriate treatment like goal-directed fluid resuscitation,anti-infection and blood purification,etc.And the patient was discharged in stable conditions.Conclusions It is easy to develop infection after liver transplantation and the fatality rate of sepsis caused by infection is high.Once the sepsis occurs,clinicians must perform early goal-directed therapy and bundle therapy according to the SSC Guidelines positively,and select the appropriate drugs according to the pathogen culture results in order to reduce the fatality rate.
