143例老年患者肾移植术后并发症分析及护理

An Analysis of Post-kidney-transplant Complications of 143 Elderly Patients and the Nursing

目的总结60岁以上终末期肾病患者肾移植术后并发症的临床特点及护理经验。方法对2000年1月—2006年4月143例年龄大于60岁的肾移植患者及同期1038例年龄<60岁肾移植患者并发症发生情况和移植后1年、3年、5年移植肾存活率进行回顾性分析比较。结果老年患者移植术后冠心病、高血压、感染、药物性肝功能损害、糖尿病发生率高于非老年患者,而急性排斥反应发生率低于非老年患者,差异均有统计学意义。结论年龄≥60岁并非肾移植的绝对禁忌证,但老年患者耐受力相对较差,常伴随其他疾病,术前准备、术后并发症的防治、免疫抑制剂不良反应监测尤为重要,应针对老年患者的特点,积极预防并发症发生,改善其预后。

Objective To sum up the features of post-kidney-transplant complications of elderly terminal-phase nephropathy patients and the nursing experience. Methods An analysis and comparison was made of the post-kidney-transplant complications and the survival rate of the transplanted kidneys 1, 3, and 5 years after the transplant between 143 elderly nephropathy patients aged 60 or above and 1 038 ones aged below 60 at the same phase of the disease. Results The incidence rate of coronary heart disease, hypertension, infections, drug-induced liver damage and diabetes among the elderly group was higher than that of the non-elderly group, and the incidence rate of acute rejection among the former, lower than that of the latter, with both differences being statistically significant. Conclusion Being aged 60 or above is not absolutely a contraindication for kidney transplant, but owing to the poor tolerance ability of the elderly patients and the resulted other diseases, pre-surgery preparations, prevention and treatment of the postsurgery complications, monitoring of adverse reactions to immunosuppressants take on great particular importance. Active measure should be taken to prevent the complications and improve the prognosis in light of the characteristics of elderly patients.