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目的:探讨肾移植术后肺部感染患者救治过程中免疫抑制剂的应用方案。方法:报告22例肺部感染的肾移植患者的临床资料。重症肺部感染13例,肺部感染早期或症状较轻的9例。前者立即停用所有免疫抑制剂,给予甲基泼尼松龙;后者减少或调整免疫移植剂用药方案等。13例检出病原菌,其中混合感染10例。结果:18例治愈,移植肾功能正常;死亡2例,放弃治疗2例。结论:对肾移植术后肺部感染及时停用或调整免疫抑制剂用量和组合方案,保护移植肾的功能和及早确定病原菌等,均有利于提高其治愈率,减少死亡率。
Objective: To explore the application of immunosuppressive agents in the treatment of patients with pulmonary infection after renal transplantation. Methods: The clinical data of 22 patients with lung-infected renal transplant were reported. Severe pulmonary infection in 13 cases, early lung infection or mild symptoms in 9 cases. The former immediately discontinued all immunosuppressive agents, giving methylprednisolone; the latter to reduce or adjust the immunosuppressive regimen and so on. 13 cases detected pathogens, including 10 cases of mixed infection. Results: 18 cases were cured, the function of renal graft was normal, 2 cases died and 2 cases abandoned treatment. Conclusion: Timely suspension or adjustment of immunosuppressant dosage and combination regimen for lung infection after renal transplantation, protection of graft function and early identification of pathogenic bacteria are beneficial to improve the cure rate and reduce the mortality rate.