CAJ | 학술논문

背景：尿毒症患者肾移植前均处于不同程度的贫血状态，围移植期贫血对机体肾移植中、后恢复以及移植肾功能恢复均产生不利影响。目的：观察接受逝世者器官捐献肾移植与亲属活体肾移植围移植期贫血程度及输血总量对肾移植的影响。总结二者围手术期药物抗贫血治疗及输血原则。方法：回顾性研究郑州大学第一附属肾移植中心2012年1月至2013年12月接受逝世器官捐献肾移植115例为试验组，对照组为同期亲属活体肾移植92例，分析两组贫血程度的相关指标以及围移植期输血总量、输血12 h内电解质的变化，记录输血后不良反应事件发生情况等。结果与结论：2组患者贫血发生率差异无显著性意义(P>0.05)；而试验组患者移植中及移植后输血比率、平均输血总量高于对照组(P<0.05)，移植前红细胞水平、血红蛋白值、红细胞压积、平均血红蛋白值含量、平均血红蛋白值浓度均明显低于对照组(P<0.05)。2组患者输血过程中主要不良事件为发热反应(5.5%)，未见严重的过敏反应及电解质酸碱平衡紊乱等。提示接受逝世者器官捐献肾移植受者较亲属活体肾移植围移植期贫血程度高；移植前抗贫血药物应用，纠正机体贫血状态至关重要；应严格按照围移植期输血原则进行移植中和(或)移植后输血治疗。
배경：뇨독증환자신이식전균처우불동정도적빈혈상태，위이식기빈혈대궤체신이식중、후회복이급이식신공능회복균산생불리영향。목적：관찰접수서세자기관연헌신이식여친속활체신이식위이식기빈혈정도급수혈총량대신이식적영향。총결이자위수술기약물항빈혈치료급수혈원칙。방법：회고성연구정주대학제일부속신이식중심2012년1월지2013년12월접수서세기관연헌신이식115례위시험조，대조조위동기친속활체신이식92례，분석량조빈혈정도적상관지표이급위이식기수혈총량、수혈12 h내전해질적변화，기록수혈후불량반응사건발생정황등。결과여결론：2조환자빈혈발생솔차이무현저성의의(P>0.05)；이시험조환자이식중급이식후수혈비솔、평균수혈총량고우대조조(P<0.05)，이식전홍세포수평、혈홍단백치、홍세포압적、평균혈홍단백치함량、평균혈홍단백치농도균명현저우대조조(P<0.05)。2조환자수혈과정중주요불량사건위발열반응(5.5%)，미견엄중적과민반응급전해질산감평형문란등。제시접수서세자기관연헌신이식수자교친속활체신이식위이식기빈혈정도고；이식전항빈혈약물응용，규정궤체빈혈상태지관중요；응엄격안조위이식기수혈원칙진행이식중화(혹)이식후수혈치료。
BACKGROUND:Uremia patients have different degree of anemia before kidney transplantation, preoperative, and perioperative anemia is harmful to intraoperative and postoperative recovery of the organism and renal function. OBJECTIVE:To observe the effects of perioperative anemia degree and total blood transfusion on non-living and living-relative donor kidney transplantation, and to summarize the perioperative drug treatment for anemia and perioperative principles of blood transfusion. METHODS: A retrospective study was done in 115 cases of non-living donor kidney transplantation (test group) and 92 cases of living-relative donor kidney transplantation (control group) from January 2012 to December 2013. Degree of anemia, total perioperative blood transfusion, electrolyte change within 12 hours of blood transfusion, and adverse events after blood transfusion were recorded and analyzed. RESULTS AND CONCLUSION:The incidence of anemia had no significant difference between the two groups (P > 0.05). Compared with the control group, the intraoperative and postoperative blood transfusion rate was higher in the test group (P < 0.05), and the preoperative red blood cel level, hemoglobin level, hematokrit, average hemoglobin level, average concentration of hemoglobin, and average amount of blood transfusions were significantly lower in the test group (P< 0.05). Fever (5.5%) was the main adverse event during the transfusion in the two groups, and there was no severe severe alergic reaction and electrolyte acid-base disturbance. These findings suggest that the perioperative degree of anemia is higher in patients undergoing non-living donor kidney transplantation and those undergoing living-relative donor kidney transplantation; preoperative drug treatment for anemia is crucial for correcting anemia status; intraoperative and/or postoperative blood transfusion treatment should be in strict accordance with the principles of perioperative blood transfusion.