肾移植患者近期心血管问题的临床研究

An short-term clinical investigation on car-diovasvular problems in renal allograft re-cipietnts

本文对３０５例（３１１次）肾移植患者移植前及移植后近期（３个月）的主要心血管并发症进行回顾性分析。结果表明，对疑为冠心病的患者应进行严格筛选，尽可能行冠脉造影术，以确定是否能行外科纠正术，术前低血压影响移植后肾功能的恢复，值得深入探讨；术前高血压是常见并发症，应寻找病因并积极处理。充分透析对纠正术前心律失常极为重要。洋地黄是术后心律失常的重要危险因素，需根据肾功能情况小心调节其用量。术后心力衰用多由容量过多引起，超滤脱水非常重要。

o understand the influence of cardio-vasvular problem on renal allograft sur-vival, a retrospective clinical survey wascontlucted.311 renal transplantation weredone in 305 patients frorn January 1986 toOctober 1992. The rnain cardiovascular corn-plications before,during and after (within 3n'ionths) renal transplantation in these pa-tients were analysed. The results suggestedthat coronary arteriography should be doneif possible in suspicious coronary artery dis-ease patients to determine whether surgicalcorrection be performed. Pre-trans plantationchronic hypotension ,which rnight affect theallograft function, deserved furthur study.Posttransplantation hypertension was acommon complication, the pathogencyshould be sought and treatment be prompt .Adequate dialysis was important for thetreatment of pretransplantation cardiac ar-rgythmias. Many kinds of cardiac arrgyth-rnias would occur after transplantation ,digi-tals was an important risk factor,the dosageshould be personized and be adjusted ac-cording to the allograft function. Posttrans-plantation cardiac failure was often causedby volume overload, hernodialysis ultrafil-tration was a critical treatment . In concul-sion, to treat the cardiovascular problemspromptly and correctly could help to in-crease the patient/graft survival rate in re-nal transplants.