在儿童肝移植后的儿科重症监护病房中,术后感染和抗菌预防
Elise Kang1, Alicia M Alcamo2, Danielle K Maue3,4
1Department of Pediatrics, Columbia University Irving Medical Center, New York, USA.
Pediatric transplantation
|August 11, 2025
概括
手术后感染 (POI) 影响了23%的儿童肝移植患者在ICU,年龄较小和张开的筋膜作为关键风险因素. 这些感染导致更糟糕的结果,包括更长的住院时间和增加的死亡率.
科学领域:
- 儿科手术 儿科手术
- 移植医学 移植医学
- 传染性疾病 传染性疾病
背景情况:
- 手术后感染 (POI) 是小儿肝移植 (LT) 后的一个重大问题.
- 了解儿科重症监护室 (PICU) 中POI的发病率和风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定儿科LT接受者在PICU停留期间的POI的发病率和风险因素.
- 评估不同移植中心的抗微生物预防利用情况.
主要方法:
- 这是一项多中心的回顾性队列研究,在两年内,来自美国12个中心的327名儿科LT接受者参与了该研究.
- 对术前和术后变量进行分析,以确定POI风险因素.
- 使用多变量后勤回归来评估POI的独立预测因素.
主要成果:
- 23%的患者患有POI,最常见的是细菌或多微生物.
- 对POI的独立预测因素包括年龄较小 (<1岁),张开的护膜和移植前住院治疗.
- POI与显著更长的住院时间,更高的移植损失率和更高的死亡率有关.
结论:
- 手术后感染在儿童肝移植接受者中很常见,影响了发病率和死亡率.
- 年轻的年龄,张开的筋膜和先前住院治疗是POI的重要风险因素.
- 需要进一步的研究来优化抗菌药物策略,减少POI发生率和相关并发症.
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