来自同一供体的肾移植患者术后并发移植肾毛霉菌感染

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

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。

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.