血液透析和腹膜透析方式与肾移植术后并发症发生的关系:204例回顾性分析  

Hemodialysis and peritoneal dialysis associated with complications following renal transplantation: A retrospective analysis in 204 cases

作　　者：符彦基[1] 王共先[2] 黄煜华[3] 

机构地区：[1]南昌大学医学院研究生部 [2]南昌大学医学院第一附属医院泌尿外科,江西省南昌市330000 [3]广东医学院附属医院内四科,广东省湛江市524000

出　　处：《中国组织工程研究与临床康复》2007年第43期8637-8640,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:由于移植肾源不足,大多数晚期尿毒症患者术前需要透析治疗。探讨血液透析和腹膜透析方式与肾移植受者术后并发症发生的关系。方法:选择2000-01/2005-12南昌大学第一附属医院泌尿外科收治的肾移植受者204例,术前透析时间大于3个月,均知情同意。按照移植术前透析方式分为两组:①血液透析组(n=122)术前采用血液透析治疗,透析10￣12h/周,手术前1日透析1次。②腹膜透析组(n=82)术前采用标准连续非卧床腹膜透析治疗,直至手术当日,在术前4￣6h排空腹透液。术后3个月拔管。两组都采用同种异体尸肾移植,术后1年内随访记录两组患者术后超急性排斥反应、急性排斥反应、细菌感染、移植肾功能延迟恢复的发生情况以及人/肾1年存活率,并进行对比分析。结果:204例肾移植受者全部进入结果分析。①两组患者肾移植术后1年内超急性排斥反应的发生率及人/肾1年存活率差异无显著性意义(P>0.05)。②血液透析组患者肾移植术后1年内急性排斥反应、细菌感染的发生率低于腹膜透析组(14.8%,25.6%;13.9%,23.2%,P均<0.05),移植肾功能延迟恢复发生率高于腹膜透析组(40.2%,20.7%,P<0.05)。结论:肾移植前腹膜透析、血液透析各有优缺点。血液透析患者的感染率低,移植肾急性排斥反应发生率低;而腹膜透析患者术后肾功能恢复较快,肾功能延迟恢复的发病率低。AIM： Because of lack of transplanted kidney, most late-stage uremia patients should receive dialysis before transplantation. This study was aimed to investigate the relationship of hemodialysis and peritoneal dialysis with postoperative complications. METHODS： 204 patients who had renal trasplantation were enrolled at Department of Urinary Surgery, First Affiliated Hospital, Nanchang University from January 2000 to December 2005. Preoperative dialysis was performed for 3 months. All patients signed the informed consent. Theywere assigned into two groups. （1）122 patients in hemodialysis group received preoperative hemodialysis, 10-12 hours in a week. One dialysis was done at day 1 before operation. （2） Eighty-two patients in peritoneal dialysis group received conventional continual ambulatory peritoneal dialysis till the time of doing operation. Dialysate was evacuated 4-6 hours before operation. Tube was removed 3 months after operation. AIIogenic cadaveric renal transplantation was conducted in the two groups. Hyperacute rejection, acute rejection, bacterial infection, occurrence of delayed renal graft function recovery and 1 year survival rates of patient/graft were recorded and compared in 1-year follow-up in the two groups. RESULTS： 204 patients who received renal transplantation were involved in the result analysis. （1）There was no significant difference in incidence of hyperacute rejection and 1 year survival rates of patient/graft between the two groups within 1 year after operation （P 〉 0.05）. （2）The incidences of acute rejection and bacterial infection were lower in the patients of hemodialysis group than the peritoneal dialysis group within 1 year after operation （14.8%,25.6%;13.9%, 23.2% ,P 〈 0.05）. The incidence of delayed renal graft function recovery was higher in the patients of hemodialysis group than the peritoneal dialysis group （40.2%,20.7%,P 〈 0.05）. CONCLUSION： Peritoneal dialysis and hemodialysis have individual characteristics. Hemodialysis patients

关 键 词：肾移植 肾功能衰竭 血液透析 器官移植 

分 类 号：R617[医药卫生—外科学]