摘要
目的：探讨肾移植术后患者发生腹泻的相关因素.方法：回顾性分析2007年1月至2012年12月北京友谊医院泌尿外科513例肾移植患者术后发生腹泻的病因、临床表现、实验室检查、治疗情况以及预后.结果：513例肾移植患者中118例（23.00%）术后出现腹泻.118例腹泻患者中65例（55.08%）考虑为服用免疫抑制剂所致,30例（25.42%）为抗生素相关性腹泻,23例（19.49%）为感染性腹泻.23例感染性腹泻中5例为细菌感染,7例为真菌感染,11例为病毒感染.84例（71.19%）患者腹泻发生于移植后1个月内,16例（13.56%）发生于移植后1~6个月,其余18例发生于移植6个月后.118例患者中84例（71.19%）经过饮食、对症处理以及调整免疫抑制剂的剂量后腹泻缓解或治愈,18例（15.25%）患者需要使用或调整抗生素治疗,16例（13.56%）患者停用吗替麦考酚酯,其后改用其他免疫抑制剂后腹泻方得以缓解或治愈.结论：肾移植术后患者腹泻的发生与患者使用免疫抑制剂、抗生素、以及并发感染等多种因素有关,区别不同病因采用相应的对症治疗可以取得良好的效果.
Objective：To investigate the factors in association with colorectal disorders in adult renal transplant recipients. Methods： A retrospective cohort study was carried out with clinical, microbiologi- cal and management data regarding diarrhea in 513 renal transplant recipients from Jan. 2007 to Dec. 2012. Results： Of the 513 patients, 118（23.00% ） with no history of ulcerative colitis, were found to have diarrhea after kidney transplantation. In the 118 patients, diarrhea was probably caused by adminis- tration of immunosuppressive agents in 65 cases （55.08%）, in 30 cases （25.42%） diarrhea was antibiotics associated, and in 23 cases （ 19.49% ） it was due to infections, including bacterial, fungal and viral infections. Diarrhea occurred soon after transplantation in most cases. Of the 118 patients, the symptom of diarrhea occurred in the first 1 month in 84 cases （71.19%）, and in the next 5 months in 16 cases （ 13.56% ）, and the other 18 cases （ 15.05% ） occurred after 180 days after transplantation. Of the 118 patients, 84 cases （71.19%） were relieved or cured after proper diets, the symptomatic therapy or the adjust meat of the doses of immunosuppressive agents： 18 cases （15.25%） needed to use or ad- just the antibiotics, 16 cases （ 13.56% ） had to stop mycophenolate mofetil and convert to other drugs. Conclusion： Immunosuppressive agents, antibiotics and infection are the common causes of diarrhea after kidney transplantation. The outcome is good with appropriate conservative management.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2013年第5期779-781,共3页
Journal of Peking University:Health Sciences
基金
国家重点基础研究发展计划(973计划
2009CB522401)资助~~
关键词
肾移植
腹泻
手术后并发症
免疫抑制剂
Kidney transplantation
Diarrhea
Postoperative complications
Immunosuppressive agents
