肾移植后伤口愈合不良的危险因素分析。

Analysis of risk factors for impaired wound healing after kidney transplantation.

机构信息

Department of Urology, Affiliated Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Department of Nursing, Affiliated Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Int Wound J. 2023 Jan;20(1):140-144. doi: 10.1111/iwj.13848. Epub 2022 May 29.

DOI:10.1111/iwj.13848

PMID:35644604

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9797925/

Abstract

To analyse risk factors for impaired wound healing after kidney transplantation to guide clinical decision-making. A retrospective analysis was performed on patients who received kidney transplantation from January 1, 2019, to May 1, 2021, at Kidney Transplantation Center in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. A case-control study was used to identify a cohort of patients with similar baseline characteristics according to 1:4 ratio. Patients were divided into two groups according to whether there was impaired wound healing after surgery. The basic data and clinical examinations between the two groups were compared, and the risk factors for impaired wound healing after kidney transplantation were analysed using univariate and multivariate analyses. According to the data type, independent samples t-test or Chi-squared test was used for comparison between groups. Furthermore, multivariate logistic regression analysis was used to analyse different risk factors and calculate the odds ratio (OR) and 95% confidence interval (CI) of each factor. A total of 18 patients showed impaired wound healing after kidney transplantation. And we conducted 72 statically matched controls. Age, diabetes, transplant types, body mass index (BMI), albumin, haemoglobin, and wound infection were statistically different between the two groups. The factors with statistically significant differences in univariate analysis were included in multivariate logistic regression analysis. The results showed that BMI > 25, fasting blood glucose level, albumin level, and prealbumin level were independent risk factors for impaired wound healing after kidney transplantation. Risk factors for impaired wound healing after kidney transplantation can be detected after surgery. Strengthening postoperative monitoring and early intervention of recipients with such factors may effectively prevent impaired wound healing after kidney transplantation.

摘要

分析肾移植后伤口愈合受损的风险因素，以指导临床决策。对 2019 年 1 月 1 日至 2021 年 5 月 1 日在上海交通大学医学院附属仁济医院肾移植中心接受肾移植的患者进行回顾性分析。采用病例对照研究，根据 1:4 的比例为相似基线特征的患者确定队列。根据术后是否存在伤口愈合受损，将患者分为两组。比较两组患者的基本资料和临床检查，采用单因素和多因素分析肾移植后伤口愈合受损的危险因素。根据数据类型，采用独立样本 t 检验或卡方检验进行组间比较。此外，采用多因素 logistic 回归分析分析不同的风险因素，并计算每个因素的比值比（OR）和 95%置信区间（CI）。共有 18 例患者肾移植后出现伤口愈合受损，我们进行了 72 例静态匹配对照。两组患者的年龄、糖尿病、移植类型、体重指数（BMI）、白蛋白、血红蛋白和伤口感染存在统计学差异。单因素分析中具有统计学差异的因素纳入多因素 logistic 回归分析。结果表明，BMI＞25、空腹血糖水平、白蛋白水平和前白蛋白水平是肾移植后伤口愈合受损的独立危险因素。肾移植后伤口愈合受损的风险因素可在术后检测到。加强对具有这些因素的受者的术后监测和早期干预，可能有效预防肾移植后伤口愈合受损。