q48例老年肾移植患者临床分析.docVIP

q48例老年肾移植患者临床分析 　　【摘要】 目的 探讨60岁以上老年患者肾移植的临床特点,以及影响肾长期存活的因素。方法 回顾性分析48例≥60岁老年肾移植患者的临床资料,并以同期0.05);老年组急性排斥反应发生率为10.4%,与对照组11.1%无显著性统计学差异(P0.05);老年组术后肺部感染、心血管疾病、肝功能异常等的发生率均高于对照组(P0.01)。老年组术后住院时间(28.0±11.7)d,显著高于对照组的(19.8±8.7)d(P0.05)。结论 老年患者进行肾移植时,心血管并发症和感染是引起死亡的主要原因。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、积极预防和及时处理并发症。 　　【关键词】老年患者;肾移植;免疫抑制剂 　　 　　Clinical analysis of renal transplantation in 48 cases with elderly patients 　　 　　YANG Tie,YANG Ai-tao.Renal trunsplantation center,,the centen hospital of Yiyang,Yiyang 413000,China 　　 　　【Abstract】 Objective To investigate the features of kidney transplantation in patients over 60 years old and along with infection renal perennial survive complication.Methods Retrospective analysis was held on 48 elderly patients aged over 60 years who underwent renal transplantation,and compared with 205 patients under the ags of 60 years who underwent the renal transplantation during the same time.Results The patient/graft survival rates of senile group at 1,3 years were 89.6%/87.5%、79.1%/75.0%,respectively with no significant difference from the control group(P0.05).The rate of acute rejection response was 10.4% inelderly patients,significantly lower than in non-elderly patients(11.1%).The postoperative incidence of pulmonary infection was higher(P0.01)and so were the hepatic dysfunction,heart failure.Conclusion Satisfactory effects could be obtained in senile patients after renal transplantation if cautious selection,rational preparation and strict match were conducted before operation and reasonable use of immunosuppressive agents,actively preventing and treating complications were performed after operation. 　　【Key words】 Eld patients;Kidney transplantation;Immunosuppressant 　　 　　随着肾脏移植技术的进步,接受肾移植的老年患者越来越多,肾移植受者的选择也不再受年龄本身的限制。本文就益阳市中心医院60岁以上老年肾移植患者的临床资料作回顾性分析,现报告如下。 　　1 资料与方法 　　1.1 一般资料 本院2004年1月至2008年12月实施的老年肾移植临床病例(老年组)48例,男29例,女19例,年龄60~71岁,平均(65.7±5.3)岁;原发病为慢性肾小球肾炎39例,糖尿病肾病5例,高血压肾病2例,多囊肾1例,慢性肾盂肾炎1例;血液透析42例,腹膜透析(CAPD)6例,透析时间(35±13