沉重的泌尿史是老年肾移植受者的危险因素

B. Z. Khubutiya, M. Khubutiya, A. Evseev, A. V. Babkina
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摘要

介绍。慢性肾衰竭多发生在既往多次泌尿外科手术后的老年患者中。泌尿系统疾病是增加肾移植并发症的一个重要因素,因为需要对现有疾病进行初步纠正。更不用说,由于伴随疾病的存在,接受者的高龄增加了移植物功能障碍的风险,使移植的近期和长期结果恶化。材料和方法。我们对在N.V. Sklifosovsky急救医学研究所接受尸体肾异体移植的124例患者的临床观察和研究进行了分析,包括来自次优供体的患者。其中,69名(55.6%)年龄大于60岁的受者被纳入主组(第1组),55名年龄小于60岁的受者(44.4%)被纳入对照组(第2组)。从第1组患者中,分离出患有泌尿系统疾病导致晚期慢性肾功能衰竭的患者,或先前因泌尿系统疾病接受过手术的患者(1A亚组,43名患者)。其余26例无泌尿系统疾病者作为b组。分析显示,1组患者术后早期几乎所有患者均出现并发症(69例患者中64例出现80例并发症,占该组患者的92.8%),而2组患者仅30.9%(55例患者中17例出现27例并发症)。同时,1组平均每1例患者出现1.2例并发症,2组平均每1例患者出现0.5例并发症,其中很大一部分并发症发生在有泌尿史负担的患者亚组(1A亚组)。有泌尿系统病史的接受者出现晚期并发症的频率也有统计学意义上的显著性差异(近2次)。老年受术者术后早期和后期并发症的发生率有统计学意义。老年受术者的泌尿史负担显著增加术后早期和晚期并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Burdened urological history as a risk factor in kidney transplantation for older age group recipients
Introduction. Chronic renal failure develops more often in elderly patients after previous repeated urological operations. Urological diseases are an important additional factor that multiply complicates kidney transplantation due to the need for preliminary correction of existing disorders. Not to mention the fact that the recipient's advanced age contributes to the risk of developing graft dysfunction due to the presence of concomitant diseases that worsen the immediate and long-term results of transplantation.Material and methods. We carried out the analysis of clinical observations and studies performed in 124 patients who underwent cadaveric renal allotransplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine, including from suboptimal donors. Of these, 69 (55.6%) recipients older than 60 years were included in the main group (group 1), and 55 recipients younger than 60 years (44.4%) – in the comparison group (group 2). From the patients of group 1, patients with urological diseases that led to the development of terminal chronic renal failure, or with previously undergone surgeries for urological diseases (subgroup 1A, 43 patients) were isolated. The remaining 26 patients who did not have urological diseases were put in subgroup 1B.Results. The analysis showed that in the early postoperative period in the recipients of group 1, complications developed in almost all the patients (80 complications in 64 of 69 patients, that is, 92.8% of patients in this group), whereas in group 2, complications developed only in 30.9% of patients (27 complications in 17 of 55 patients). At the same time, on average, 1.2 complications per 1 patient were noted in group 1, and 0.5 complications per 1 patient in group 2, a significant part of the complications occurred in the subgroup of patients with a burdened urological history (subgroup 1A). Late complications also developed statistically significantly more often (almost 2 times) in recipients with a burdened urological history.Conclusions. Complications of the early and late postoperative period develop statistically significantly more often in elderly recipients. The presence of a burdened urological history in elderly recipients significantly increases the risk of early and late postoperative complications.
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