围手术期麻醉相关因素对心脏死亡器官捐献肾移植患者发生移植肾功能延迟恢复的影响  

Effect of perioperative anesthesia⁃associated factors on the occurrence of delayed graft function in patients undergoing donation after cardiac death renal transplantation

作　　者：伍江明 李洪 WU Jiangming;LI Hong(Department of Anesthesiology,No.924 Hospital of The Chinese People's Liberation Army Joint Logistic Support Force,Guilin 541002,Guangxi,China)

机构地区：[1]中国人民解放军联勤保障部队第九二四医院麻醉科,广西桂林市541002

出　　处：《广西医学》2024年第9期1342-1347,共6页Guangxi Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-C20221049)。

摘　　要：目的 探讨围手术期麻醉相关因素对心脏死亡器官捐献(DCD)肾移植患者发生移植肾功能延迟恢复(DGF)的影响。方法 回顾性分析232例行DCD肾移植术患者的临床资料,将术后发生DGF患者纳入DGF组,术后移植肾功能即刻恢复(IGF)患者纳入IGF组。采用多因素Logistic回归模型分析围手术期麻醉相关因素对DCD肾移植术后发生DGF的影响。结果 IGF组患者术中尿量、术中液体总量、术中七氟醚使用率、术后氢吗啡酮使用率高于DGF组患者(P<0.05)。多因素Logistic回归分析结果显示,术中尿量为1~300 mL、术后使用氢吗啡酮是DCD肾移植术后DGF发生的保护因素(P<0.05)。结论 在DCD肾移植术围手术期中,维持患者适当的术中尿量、术后使用氢吗啡酮镇痛可减少DCD肾移植术后DGF的发生。Objective To explore the effect of perioperative anesthesia-associated factors on the occurrence of delayed graft function(DGF)in patients undergoing donation after cardiac death(DCD)renal transplantation.Methods The clinical data of 232 patients who underwent DCD renal transplantation were retrospectively analyzed,and patients suffering from DGF after surgery were enrolled into DGF group,whereas patients experiencing postoperative immediate graft function(IGF)were into the IGF group.The effect of perioperative anesthesia-associated factors for the occurrence of DGF after DCD renal transplantation was analyzed by employing the multivariate Logistic regression model.Results The IGF group exhibited higher intraoperative urine volume,total intraoperative fluid volume,intraoperative sevoflurane use frequency,and postoperative hydromorphone use frequency as compared with the DGF group(P<0.05).The results of multivariate Logistic regression analysis revealed that intraoperative urine volume of 1-300 mL,and postoperative hydromorphone use were the protective factors for the occurrence of DGF after DCD renal transplantation(P<0.05).Conclusion During the perioperative period of DCD renal transplantation,maintaining appropriate intraoperative urine volume and postoperative use of hydromorphone for analgesia can reduce the occurrence of DGF after DCD renal transplantation.

关 键 词：肾移植 心脏死亡器官捐献 移植肾功能延迟恢复 围手术期麻醉 

分 类 号：R614.1[医药卫生—麻醉学]