老年肾移植患者的临床特点与护理效果分析

Clinical features and nursing effect analysis of elderly patients with renal transplantation

目的探讨60岁以上老年患者肾移植的临床特点及护理措施。方法回顾性分析48例≥60岁的老年肾移植患者（老年组）的临床资料，并以同期〈60岁的肾移植患者205例作对照（对照组）进行对比分析。结果老年组切口甲级愈合率、肌酐恢复正常时间、1个月后血肌酐及1个月后测定的血红蛋白含量与对照组比较，差异无统计学意义（P〉0．05）。而住院时间老年组长于对照组，两组比较差异有统计学意义（P〈0．05）；老年组人／肾1、3年存活率分别为89．6％／87．5％、79．1％／75．0％，对照组分别为92．7％／91．7％、81．0％／76．1％，两组比较差异无统计学意义（P〉0．05）；老年组急性排斥反应发生率为10．4％，与对照组的11．1％比较差异无统计学意义（P〉0．05）；老年组白细胞减少、肝功能异常、肺部感染、术后糖尿病及心血管疾病发生率与对照组比较，差异有统计学意义（P〈0．01）。结论老年患者进行肾移植时，术前应慎重选择、充分准备、严格配型：术后合理使用免疫抑制剂，细心护理，积极预防和及时处理并发症，以提高手术成功率及人／肾存活率。

Objective To investigate the clinical characteristics and nursing measures of elderly patients with renal transplantation. Methods The clinical data of 48 cases of renal transplantation patients age above 60 years （ elderly group） , and in the same period 205 cases of renal transplantation age below 60 years as control group （control group） were compared and analyzed. Results The incision after healing rate, creatinine returned to normal time, serum creatinine after 1 month and the hemoglobin concentration of the elderly group in comparison with the control group, there was no significant difference （P 〈 0. 05）, The person/kidney 1, 3 year survival rates of the elderly group were 89.6%/87.5%, 79. 1%/75% , and were 92. 7%/91.7% , 81.0%/76. 1% in the control group, there was no significant difference between the two groups （P 〉 0. 05 ）. The acute rejection rate of the elderly group was 10.4% ,and was 11.1% in control group, there was no significant difference （ P 〉 0. 05）. The decreased white blood cells, abnormal liver function, pulmonary infection, postoperative diabetes and cardi- ovascular disease incidence of the two groups have significant differences （ P 〈 0.01 ）. Conclusions When elderly patients undergoing renal transplantation, preoperative treatment should be carefully chosen, full preparation, strict matching ; postoperative reasonable use of immunosuppressants, careful nursing, active prevention and prompt treatment of complications should be made, to improve the success rate of the operation and the patient/graft survival rate.