来自同一供体的肾移植患者术后并发移植肾毛霉菌感染

张善斌; 肖劲逐; 张国庆; 车宪平; 陈宁; 古军; 符仕宝; 李德胜

doi:10.3969/j.issn.1674-7445.2015.05.013

来自同一供体的肾移植患者术后并发移植肾毛霉菌感染

doi: 10.3969/j.issn.1674-7445.2015.05.013

571300 海口, 海南省农垦总医院泌尿外科

基金项目:

海南省重点科研课题 1421320

海南省重点科研课题 27A1004

详细信息

通讯作者:
肖劲逐, Email:xiaonkyy@126.com

中图分类号: R617;R379
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- PDF下载量: 16
- 被引次数: 0
出版历程
- 收稿日期: 2015-07-20
- 网络出版日期: 2021-04-29
- 刊出日期: 2015-09-01

Mucor infection in renal grafts from the same donor after renal transplantation

Department of Urinary Surgery, Hainan Provincial Nongken General Hospital, Haikou 571300, China

More Information

Corresponding author: Xiao Jinzhu, Email:xiaonkyy@126.com

摘要

摘要: 目的总结移植肾毛霉菌感染的诊治经验。方法回顾性分析来自同一供体的两例移植肾毛霉菌感染致移植肾及动脉破裂病例的临床资料, 并复习国内外相关文献。 结果与结论 肾移植术后毛霉菌感染无特异性表现, 缺乏早期诊断手段, 容易误诊、漏诊, 其易致血管破裂, 预后凶险。及早确诊, 彻底清创, 及时选择有效抗真菌药物及撤除免疫抑制剂, 血栓弹力图监控下纠正机体凝血功能紊乱, 可提高此类患者存活率。
- 肾移植 /
- 毛霉菌 /
- 毛霉病 /
- 动脉瘤血栓 /
- 血栓弹力图
Abstract: Objective To summarize the diagnosis and treatment experience of mucor infection in renal grafts. Methods Clinical data of two patients with mucor infection in renal grafts from the same kidney donor that finally caused renal graft and renal artery rupture were retrospectively studied, and the relevant domestic and foreign literatures were reviewed. Results and conclusions Mucor infection after renal transplantation has no specific manifestation, thus it lacks of means of early diagnosis and is easy to cause misdiagnosis and missed diagnosis. Mucor infection is easy to cause vascular rupture and the prognosis is poor. Early diagnosis, thorough debridement, timely selection of effective antifungal agent, withdrawal of immunosuppressant and correction of coagulation disorders under the monitor of thrombelastogram may improve the survival rate of such patients.
- Renal transplantation /
- Mucor /
- Mucormycosis /
- Aneurysm thrombosis /
- Thrombelastogram

HTML全文

表 1 肾移植患者(例2)血肿穿刺后各时间点的血栓弹力图指标变化

Table 1. Changes of thrombelastography after the hematoma puncture of a renal transplant patient(Case 2)

时间	反应时间(min)	K值(min)	Angle角(°)	最大振幅(mm)	LY30(%)
穿刺后第1日	8.4	1.7	67.7	52.5	12.3
穿刺后第3日¹	10.2	1.6	70.5	72.9	6.8
穿刺后第4日	4.6	1.1	75.5	70.2	5.6
正常参考值	3～8	1～3	53～72	50～70	< 8
注：¹为氨甲环酸治疗后2 d

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