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心脏手术联合肾移植与心脏手术后肾移植的结局比较。

Outcomes of combined cardiac surgery and kidney transplant compared with kidney transplant after cardiac surgery.

作者信息

Zengin Mehdi, Rabus Murat Bulent, Tekin Sabri, Yucetin Levent, Demirbas Alper, Bayezid Omer

机构信息

Medicalpark Antalya Hospital, Antalya, Turkey.

Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.

出版信息

Prog Transplant. 2014 Dec;24(4):349-54. doi: 10.7182/pit2014806.

Abstract

CONTEXT

Patients with chronic renal failure have a high prevalence of coronary artery disease and cardiovascular death. The mortality and the morbidity rates of cardiac surgery are particularly high in these patients with end-stage renal disease. Performing cardiac surgery and kidney transplant in the same session can reduce these complications in the early postoperative period by normalizing renal function.

OBJECTIVE

To compare the mortality and morbidity rates between patients who had undergone cardiac surgery and kidney transplant separately and patients who had combined surgeries.

METHODS

This retrospective study consisted of 75 patients. One group of 60 patients underwent cardiac surgery and kidney transplant in separate sessions, and the other group of 15 patients had combined surgeries in the same session, between March 2008 and September 2012.

RESULTS

Patients who had combined surgeries achieved fluid electrolytic balance more easily, had shorter extubation times, used less blood and blood products, and had fewer major complications. The patients recovered faster and thus had shorter stays in the intensive care unit and hospital. This combined surgical approach allows normalized kidney function in patients with end-stage renal disease, so mortality and morbidity in the early postoperative period could be significantly reduced.

摘要

背景

慢性肾衰竭患者冠状动脉疾病和心血管死亡的患病率很高。在这些终末期肾病患者中,心脏手术的死亡率和发病率尤其高。在同一次手术中进行心脏手术和肾移植可以通过使肾功能正常化来减少术后早期的这些并发症。

目的

比较分别接受心脏手术和肾移植的患者与接受联合手术的患者的死亡率和发病率。

方法

这项回顾性研究包括75例患者。2008年3月至2012年9月期间,一组60例患者分别接受心脏手术和肾移植,另一组15例患者在同一次手术中接受联合手术。

结果

接受联合手术的患者更容易实现水电解质平衡,拔管时间更短,使用的血液和血液制品更少,主要并发症也更少。患者恢复更快,因此在重症监护病房和医院的住院时间更短。这种联合手术方法可使终末期肾病患者的肾功能正常化,从而可显著降低术后早期的死亡率和发病率。

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