Đặc điểm của người bệnh viêm phổi sau ghép thận

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Như Xuân Hà, Quang Huy Nguyễn

Ngôn ngữ: Vie

Ký hiệu phân loại: 612 Human physiology

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam) 2022

Mô tả vật lý: 192-204

Bộ sưu tập: Metadata

ID: 403047

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Đánh giá đặc điểm lâm sàng, cận lâm sàng của người bệnh viêm phổi sau ghép thận. Đối tượng và phương pháp. Nghiên cứu mô tả cắt ngang 127 người bệnh viêm phổi sau ghép thận đang theo dõi sau ghép tại phòng khám ghép thận bệnh viện Chợ Rẫy trong thời gian 01/12/2021 đến 01/06/2022. Kết quả. Nghiên cứu 127 trường hợp viêm phổi sau ghép thận cho kết quả viêm phổi do nhiễm Pneumocystis jirovecii (PJP) chiếm tỷ lệ 40,9% mặc dù tất cả người bệnh đều được dự phòng thuốc Trimethoprim-Sulfamethoxazole (TMP-SMX) sau ghép 5.3 ± 3 tháng. Người bệnh viêm phổi sau ghép có 49,6% tăng huyết áp, 38,6% sốt (38oC đến 39oC), ho chiếm 55,9%, khó thở chiếm 41% và đau ngực chiếm 35,4%. Chức năng thận của người bệnh bất thường với chỉ số Creatinine 1.61 ± 0.84 mg/dL tăng cao và eGFR 57.35 ± 22.42 mL/min/ 1.73m2 giảm dần. Hệ miễn dịch suy giảm với các thông số miễn dịch bất thường CD3: 890,13 ± 458,13 tế bào/ul, CD8: 394,1 ± 237,8 tế bào/ul, CD4: 429,36 ± 270,95 tế bào/ul. Kết luận. Các đặc điểm lâm sàng, cận lâm sàng tại thời điểm người bệnh nhập viện điều trị viêm phổi sau ghép thận nhìn chung đều có biểu hiện đặc trưng cho bệnh viêm phổi, hầu hết các thống số chức năng nằm ở mức giới hạn bất thường. Điều này khuyến cáo nhân viên y tế cần quan tâm tư vấn, giáo dục sức khoẻ phòng ngừa viêm phổi cho những người bệnh sau ghép thận., Tóm tắt tiếng anh, Evaluation of clinical and laboratorical characteristics of patients with pneumonia after kidney transplant. Method. A cross-sectional descriptive study of 127 pneumonia patients after kidney transplant who were being monitored after transplantation at the kidney transplant clinic of Cho Ray hospital from December 2021 to June 2022. Results. Among 127 cases pneumonia after kidney transplant, research find out the Pneumocystis jirovecii (PJP) infection accounted for a high rate of (40.9%) in patients although all of them received Trimethoprim- Sulfamethoxazole prophylaxis (TMP-SMX) 5.3 ± 3 months after transplantation. Patients increased hypertention with 49.6%, 38.6% fever (38oC- 39oC), cough 55.9%, dyspnea 41% and chest pain with 35.4%. Patients had abnormal renal function with Creatinine 1.61 ± 0.84 mg/dL increased and eGFR 57.35 ± 22.42 mL/min/1.73 m2 gradually decreased. The immune system is impaired with the immune parameters are abnormal CD3: 890.13 ± 458.13 cells/ul, CD8: 394.1 ± 237.8 cells/ul, CD4: 429.36 ± 270.95 cell/ul. Conclusions. The clinical and laboratorical characteristics of patients at the admission to the hospital because of pneumonia after kidney transplant showed that most of symptoms typically presents pneumonia and the parameter's function were at abnormal limits. This recommends that medical staff should pay attention to health counseling and education to prevent pneumonia for patients after kidney transplant.

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