胰肾联合移植术后麻痹性肠梗阻相关危险因素分析  

Risk factors of paralyticileus after simultaneous pancreas-kidney transplantation

作　　者：涂金鹏[1] 付迎欣[1] 史晓峰[1] 裴广辉[1] 冯钢[1] 赵杰[1] 王振[1] 王辉[1] 莫春柏[1] Tu Jinpeng;Fu Yingxin;Shi Xiaofeng;Pei Guanghui;Feng Gang;Zhao Jie;Wang Zhen;Wang Hui;Mo Chunbai(Department of Kidney Transplantation,First Central Municipal Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院肾移植科,300192

出　　处：《中华器官移植杂志》2021年第7期404-407,共4页Chinese Journal of Organ Transplantation

基　　金：天津市卫生健康委员会科技项目(RC20122、RC20128、ZC20167、RC20111、ZC20227、RC20090)。

摘　　要：目的分析胰肾联合移植术后麻痹性肠梗阻发生的相关危险因素。方法纳入天津市第一中心医院2017年1月至2019年12月行胰肾联合移植术受者115例,回顾性分析胰肾联合移植术后麻痹性肠梗阻发生的相关危险因素。根据术后麻痹性肠梗阻的发生情况,将受者分为肠梗阻组19例和非肠梗阻组96例。采用单因素方差分析性别、年龄、体重指数、糖尿病类型、糖尿病患病时间、透析方式、透析时间、糖尿病性胃肠病史、腹部手术史、肠道准备、手术时间、出血量、免疫抑制剂方案、低蛋白血症等因素对于麻痹性肠梗阻发生率的影响。将筛选的可疑危险因素进行多因素Logistic回归分析探讨受者术后发生麻痹性肠梗阻的独立危险因素。结果115例受者中,术后发生麻痹性肠梗阻19例(16.5%)。单因素分析结果显示,存在糖尿病性胃肠病史、手术时间、开腹手术史、无肠道准备、低蛋白血症的受者麻痹性肠梗阻发生率高(P<0.05)。多因素Logistic回归分析的结果显示,糖尿病性胃肠病史、手术时间、开腹手术史、无肠道准备是术后麻痹性肠梗阻发生的危险因素(P<0.05)。结论胰肾联合移植术后麻痹性肠梗阻发生的相关危险因素包括糖尿病性胃肠病史、手术时间、开腹手术史和无肠道准备,临床工作中应对上述因素予以干预。Objective To explore the risk factors of paralytic ileus(PI)after simultaneous pancreas-kidney(SPK)transplantation.Methods From January 2017 to December 2019,clinical data were reviewed retrospectively for 115 cases of SPK transplantation.The risk factors of PI after SPK were analyzed.According to the occurrence of PI,they were divided into two groups of occurrence and non-occurrence.One-way analysis of variance was utilized for analyzing such influencing factors as gender,age,body mass index(BMI),diabetic type,duration of diabetes,mode of dialysis,duration of dialysis,diabetic gastroenterology,history of open surgery,bowel preparation,operative duration,hemorrhagic volume,immunosuppressant and hypoproteinemia.Multivariate Logistic regression analysis was performed for screening the suspected risk factors.Results Among them,19 patients(16.5%)had PI.Univariate analysis showed that PI was associated with diabetic gastroenterology,operative duration,history of open surgery,no bowel preparation and hypoproteinemia(P<0.05).Multivariate Logistic regression analysis revealed that the risk factors of PI after SPK included diabetic gastroenterology,operative duration time,history of open surgery and no bowel preparation(P<0.05).Conclusions Diabetic gastroenterology,operative duration,history of open surgery and no bowel preparation are risk factors for PI after SPK.Clinical interventions for the above factors are necessary.

关 键 词：胰肾联合移植 麻痹性肠梗阻 危险因素 

分 类 号：R699.2[医药卫生—泌尿科学] R657.5[医药卫生—外科学]