Abstract:

Objective The clinical effects of antifungal application in kidney transplant patients were analyzed to evaluate their efficacy and safety. Methods The clinical data of 155 perioperative renal transplantation patients from 2017 to 2021 were retrospectively analysed. There were 64 cases in the control group and 91 cases in the prevention group. The patients were followed up for 12 months，and the fungal infection of the patients were recorded. Results There were 5 cases of fungal infection in the control group. In the prevention group，there were only 3 cases of fungal infection. The incidence was 7.81% and 3.30%，respectively. There was no significant difference between the two groups after statistical analysis. The incidence of early stage infection in the control group was 60%，and the incidence of late infection（＞ 4 months after transplantation）was 40%. While the incidence of early stage infection in the prevention group was 100%，the incidence of late stage infection did not occur. Conclusion The late stage infection rate in the prevention group was lower than that in the control group，suggesting that perioperative prevention of fungal infection has a certain positive effect on late infection. But due to the limitations of samples，small sample size and short follow-up time in our center，the efficacy，safety and economy of prophylactic antifungal drugs under multi-center hierarchical management still need to be further studied. 

Key words:

Renal transplant, Perioperative period, Prophylaxis, Fungal infection

摘要：

目的 分析肾移植患者围术期应用抗真菌药物的临床效果，评价其疗效和安全性。方法回顾性分析 2017 — 2021 年湖北医药学院附属国药东风医院肾移植围术期患者临床资料 155 例。未预防应用抗真菌药物作为对照组，预防用药作为预防组，对照组 64 例，预防组 91 例，随访同期 12 个月，统计分析患者真菌感染情况。结果 对照组 64 例有 5 例真菌感染，而预防组 91 例 3 例真菌感染，发生率分别为 7.81%、3.30%，二者统计学无明显差异。而对照组早期感染发生率为 60%，晚期感染（移植后＞ 4 个月）发生率为40%，预防组早期感染发生率为 100%，晚期感染未发生。 结论 预防组的晚期感染率低于对照组，提示围术期预防真菌感染对于晚期感染有一定积极作用。但由于本中心样本具有局限性、样本量偏少、随访时间短等，多中心分级管理下预防抗真菌药物的疗效性、安全性与经济性还需进一步研究。

关键词:

肾移植 , 围术期 , 预防 , 真菌感染