摘要
目的探讨肾移植术后肺结核感染的早期诊断和治疗。方法回顾性分析12例肾移植术后肺结核感染患者的临床资料。均采取免疫抑制剂减量或停用,加大糖皮质激素剂量,异烟肼+利福平+乙胺丁醇或吡嗪酰胺三联抗结核疗法,辅以营养支持治疗。结果12例患者均在1个月左右症状缓解出院,并常规抗结核6～15个月后痊愈。结论胸部X线、痰涂片或培养、PPD、血Anti-TBAb及PCR等综合检测,结合临床表现是早期诊断的关键。调整免疫抑制方案,增加糖皮质激素用量,果断采取抗结核治疗以及营养支持治疗,将有助改善患者的预后。
Objective To study the early diagnosis and management of the patients with tuberculosis after renal transplantation. Methods The clinical data of 12 cases of tuberculosis after renal transplantation were retrospectively analyzed. The dose of immunosuppressant was reduced or it was withdrawn, the dose of glucocorticoids was increased, and all patients were subjected to the treatment of isonicotinylhydrazine （INH） ＋ rifampin （RFP） ＋ ethambutol （EB） or pyrazinamide （PZA） and assisted with nutrition supply. Results Twelve patients obtained remission of symptoms in one month, and cured with antituberculotic after 6 to 15 months. Conclusion The key of early diagnosis lies in chest X - ray or tuberculosis culture or PPD or blood antituberculotic antibody, PCR, etc, in combined with clinical presentation. Adjustment of immunosuppressant dosage, decisive administration with antituberculotic and early management with nutrition supply are important for the treatment of patients with tuberculosis after renal transplantation.
出处
《临床外科杂志》
2007年第9期622-623,共2页
Journal of Clinical Surgery
关键词
肾移植
肺结核
综合检测
renal transplantation
tuberculosis
combined modality test
