老年患者肾移植的围手术期治疗

Therapy during perioperation in aged recipients of kidney transplantation

目的 探讨老年患者肾移植的临床特点和围手术期治疗要点 ,提高老年肾移植患者人 /肾存活率。方法 对 2 7例老年肾移植患者的临床资料进行分析总结。结果 2 1例发生各类并发症 ,主要有感染和药物性肝功能损害等 ,治疗后 1 9例恢复正常 ,治愈率 90 .5%。 1、3年人 /肾存活例数分别为 2 5/ 2 5,2 3/ 2 1 ;存活率分别为 92 .6% / 92 .6% ;85.2 % / 77.8%。结论 术前全身状态差 ,术后并发症多时老年肾移植患者的主要临床特点 ,也是制约其人 /肾存活率的主要因素 ;完善围手术期治疗措施 ,及时准确检测 ,合理调整用药是提高老年肾移植患者人 /肾长期存活的重要保证。

Objective To study the clinical characters and the therapeutic experience of aged cadaveric kidney transplant recipients, and improve transplantation long term survivals.Methods The data of kidney transplantation in 27 aged patients were summed up and analyzed.Results The various post-operative complications occurred in 21 recipients(77.8%), including many kinds of infections and hepatic dysfunction resulted from immuno-suppressive drugs, 19 of them recovered after proper therapy(90.5%). The 1,3 year survival cases and rate of patient/graft kidney were 25/25 and 23/21,92.6%/92.6% and 85.2%/77.8%, respectively.Conclusions Bad pre-operative health condition and more post-operative complications were the clinical characters of kidney transplantation in aged recipients, and were also the main factors that affected the rate of patient/graft kidney survival; consummate treatment during perioperation, examination in time, reasonable medicine therapy were the guarantee of improving transplantation long term survivals.