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Chest:肺移植受者非结核分枝杆菌围手术期和术后治疗方案的结局

2020-04-06 xiangting MedSci原创

除脓肿分枝杆菌以外,LTX时诊断的NTM-PD患者可以得到安全治疗,并且移植后的NTM-PD发生率没有显著升高。

鉴于肺移植(LTX)候选者的严重呼吸道疾病,一些人可能会出现非结核分枝杆菌-肺病(NTM-PD)。但是目前LTX时NTM-PD的适当治疗尚不清楚。因此,这项研究给出了围移植期的NTM-PD治疗方案,NTM-PD定义为外植体中存在肉芽肿和NTM的分枝杆菌证据。

2013年至2014年,对移植后存活超过30天的230例LTX受者(LTRs)进行随访,直至2017年。其中7.8%的LTRs(18/230)被诊断为围移植期NTM-PD,并按照方案使用阿奇霉素250mg/天、乙胺丁醇15mg/kg/天和莫西沙星400mg/天治疗12个月。只要在移植后的早期阶段使用抗分枝杆菌药物进行治疗,伴/不伴围移植期NTM-PD患者的移植后NTM-PD(p=0.362)、慢性同种异体肺移植功能障碍(p=0.530)和死亡率(p=0.152)没有显著差异。

除脓肿分枝杆菌以外,LTX时诊断的NTM-PD患者可以得到安全治疗,并且移植后的NTM-PD发生率没有显著升高。

原始出处:

Takashi Hirama. Outcomes of a Peri and Post-operative management protocol for Nontuberculous mycobacteria in lung transplant recipients. Chest. 02 April 2020.

 

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    2021-02-20 Smile2680
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近日,一篇关于全国首例尘肺病医生获失职罪的报道,引医疗行业关注。据《医师报》报道,贵州航天医院三位医生家属发来《求助信》,信中提到,三位医生从事尘肺病诊断工作,在正常履行医生职责的情况下,被公安机关定罪,理由为尘肺病诊断中客观存在的诊断读片差异为医生“严重不负责任”,并以“涉嫌国有事业单位人员失职罪”的罪名无辜羁押7个多月。纵观整个案件,不难发现其中疑点重重。围绕尘肺病的“读片差异率”,医生方

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