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肾移植受者术前身体活动水平及其对术后早期恢复影响的调查:一项回顾性队列研究。

Investigation of preoperative physical activity level in kidney transplant recipients and its impact on early postoperative recovery: A retrospective cohort study.

作者信息

Li Guo, Guo Qi-Fan, Zhao Shang-Ping, Wang Miao-Wei, Zhang Xia, Wang Ao, Gui Chen-Fan, Tan Qi-Ling, Gao Qiang

机构信息

Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Rublic of China.

Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Surg. 2023 Jan 6;9:1062652. doi: 10.3389/fsurg.2022.1062652. eCollection 2022.

Abstract

OBJECTIVE

To retrospectively investigate the preoperative physical activity (PA) level in kidney transplant recipients (KTRs) and its impact on early postoperative recovery.

METHODS

A total of 113 patients who received kidney transplantation at West China Hospital of Sichuan University were enrolled in this retrospective cohort study. According to the PA level measured by the Chinese version of the International Physical Activity Questionnaire-Long Version, the patients were allocated into the low PA level group (Group L,  = 55) and medium to high PA level group (Group MH,  = 58). The kidney function recovery indicators, including estimated glomerular filtration rate (eGFR), postoperative complications, postoperative length of stay (LOS), and unscheduled readmission within three months of discharge, were evaluated and documented. A association analysis was applied to analyze and compare the association between indicators.

RESULTS

The median PA levels of the KTRs were 1701.0 MTEs * min/week. Regarding the postoperative recovery indicators, the KTRs spent a mean time of 19.63 h to achieve transfer out of bed after the operation (Group L: 19.67 h; Group MH: 19.53 h;  = 0.952) and reached a mean distance of 183.10 m as the best ambulatory training score within two days after the operation (Group L: 134.91 m; Group MH: 228.79 m;  < 0.001). The preoperative PA level showed a moderate positive association with early postoperative ambulation distance ( = 0.497,  < 0.001). However, no significant between-group difference in eGFR on postoperative days 1, 3, and 5 ( = 0.913, 0.335, and 0.524) or postoperative complications, including DGF ( = 0.436), infection ( = 0.479), postoperative LOS ( = 0.103), and unscheduled readmission ( = 0.698), was found.

CONCLUSIONS

The preoperative PA level of KTRs is lower than that of the general population. KTRs with moderate or high preoperative PA levels showed higher ambulatory function in the early postoperative period than those with low preoperative PA levels, but no between-group differences in other early recovery indicators were observed.

摘要

目的

回顾性调查肾移植受者(KTRs)术前的身体活动(PA)水平及其对术后早期恢复的影响。

方法

本回顾性队列研究纳入了四川大学华西医院的113例接受肾移植的患者。根据中文版国际身体活动问卷长版测量的PA水平,将患者分为低PA水平组(L组,n = 55)和中高PA水平组(MH组,n = 58)。评估并记录肾功能恢复指标,包括估计肾小球滤过率(eGFR)、术后并发症、术后住院时间(LOS)以及出院后三个月内的非计划再入院情况。采用相关性分析来分析和比较各指标之间的相关性。

结果

KTRs的PA水平中位数为1701.0梅脱·分钟/周。关于术后恢复指标,KTRs术后达到下床活动的平均时间为19.63小时(L组:19.67小时;MH组:19.53小时;P = 0.952),术后两天内最佳步行训练成绩的平均距离为183.10米(L组:134.91米;MH组:228.79米;P < 0.001)。术前PA水平与术后早期步行距离呈中度正相关(r = 0.497,P < 0.001)。然而,术后第1、3和5天的eGFR组间差异无统计学意义(P = 0.913、0.335和0.524),术后并发症包括移植肾功能延迟恢复(DGF,P = 0.436)、感染(P = 0.479)、术后住院时间(P = 0.103)和非计划再入院(P = 0.698)也未发现组间差异。

结论

KTRs术前的PA水平低于一般人群。术前PA水平为中度或高度的KTRs在术后早期的步行功能高于术前PA水平低的患者,但在其他早期恢复指标上未观察到组间差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f51/9852711/5c26faeef6da/fsurg-09-1062652-g001.jpg

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