对27例亲属供肾移植中供者的术后随访

Follow-up of living related kidney donors(27 cases report)

目的探讨活体亲属供肾移植中供者手术的安全性及术后的生活质量。方法总结2001年12月至2005年9月间27例亲属活体供肾的切取方法,其中6例采用开放式经后腹腔切取供肾,21例采用经后腹腔镜下切取供肾。术后对27例供者随访14～60个月,比较供者术前及术后不同时间段的血肌酐(Cr)、尿素氮(BUN)、血糖及血压的变化情况;根据SF-36健康评分调查和25条问卷题目观察供者的生活质量。结果成功地完成了对27例亲属供者的供肾切取。21例经腹腔镜下取肾术无1例中转开放。手术时间为60～180 min,术中失血量为20～200 ml,术后住院时间为3～7d。27例供者术后近期各项观察指标虽较术前有变化,但差异均无统计学意义(P>0.05)。健康评分结果显示供者生活质量满意。结论活体供肾切取手术是安全可行的。术前进行详细的检查、术中仔细操作以及术后长期随访对于供者的安全有十分重要的意义。

Objective To explore the safety and long-term quality of life in the living kidney donors. Methods The data of 27 donors （6 cases by open approach, 21 cases by laparoscopies） who received live donor nephrectomy in the Third Affiliated Hospital of Beijing University from December 2001 to September 2005 were summarized. Donors were followed up for 14-60 months. The Cr, BUN, BP and glucose metabolism level in the patients before and after nephrectomy at different time points were examined. The quality of life in living donors was observed by short form 36-health questionnaire survey and 25 questions. Results The operations of 27 living donors were very successful. None of 21 cases subject to retroperitoneoscopic nephrectomy experienced conversion to open surgery. The operative time was 60-180 min, the blood loss was 20-200 ml and the mean hospital stay was 3 -7 days. The changes of Cr, BUN, BP and glucose metabolism level in all cases were observed during the period of follow-up. But the differences were not significant statistically （P〉0. 05）. Quality of life in all the cases was satisfactory. Conclusions The living donor nephrectomy is feasible and safe. It is very important to examine living donor before operation, operate very carefully and perform longterm follow-up.