Abstract:

Objective To explore the role of non-invasive and invasive ventilation in cytomegalovirus （CMV） pneumonia induced severe acute respiratory distress syndrome（ARDS）after renaltransplantation. Methods A case of postoperative renal transplant CMV pneumonia and severe ARDS and literature were reviewed. Results More than 3 months after renal transplantation，the patient underwent fever andshort of breath. The chest radiographshowed bilateral pulmonary interstitial changes. His condition gradually worsenedwith obviously difficult breathing and the lowest oxygen partial pressure was 20 mmHg（1 mmHg ＝ 0.133 kPa） despite the conventional treatment. Noninvasive ventilation was given in time，and was changed to invasive ventilation according to the condition. Two weeks after the ventilation treatment，non-invasive ventilator was used again as the disease alleviated. The patient was treated for a total of 1 month before discharge. Conclusion With the timely and appropriate application of non-invasive and invasive ventilation in CMV pneumonia induced severe ARDS after renal transplantation，pulmonary function can be improved and the chance for the treatment of primary disease was won.

Key words: Renal transplantation ； Cytomegalovirus infection ； Pneumonia ； Acute respiratory , distress syndrome； Ventilation

摘要：

目的 探讨无创、有创呼吸机在肾移植术后巨细胞病毒（CMV）肺炎并严重急性呼吸窘迫综合征（ARDS）的价值。方法 介绍 1 例肾移植术后出现 CMV 肺炎并严重 ARDS 临床资料并文献复习。结 果 患者肾移植术后 3 月余，出现发热、憋喘，X 线胸片显示双肺间质性改变，常规治疗下，病情逐渐加 重，呼吸困难明显，最低氧分压（PaO2）20 mmHg（1 mmHg ＝ 0.133 kPa），及时给予无创呼吸机辅助呼吸，根据病情更换有创呼吸机治疗，应用 2 周后，病情减轻再次更换为无创呼吸机，共治疗 1 个月，痊愈出院。结论 无创、有创呼吸机在肾移植术后 CMV 肺炎合并严重 ARDS 及时恰当应用，肺功能得到改善，为患者提供了治疗原发病的时机。

关键词: 肾移植 , 巨细胞病毒 , 肺炎 , 急性呼吸窘迫综合征 , 呼吸机