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探讨肾移植术后与伤口相关的并发症。

Exploration of wound-related complications post-kidney transplantation.

机构信息

Department of Organ Transplantation, Qilu Hospital of Shandong University, Shandong, China.

出版信息

Int Wound J. 2024 Apr;21(4):e14578. doi: 10.1111/iwj.14578. Epub 2023 Dec 19.

Abstract

An essential intervention for patients with end-stage renal disease is kidney transplantation. Nonetheless, patient outcomes are substantially affected by complications associated with postoperative wounds. The purpose of this research was to determine the prevalence, risk factors and repercussions of wound-related complications among kidney transplant recipients. A cross-sectional observational study was undertaken at Qilu Hospital of Shandong University Department of Organ Transplantation, China. Included in the study were 118 patients who had undergone kidney transplantation during the specified time period. Medical record evaluations, questionnaires and patient interviews were utilized to collect data, with an emphasis on demographics, transplant information, postoperative care and wound complications. Infection, dehiscence, lymphocoele, delayed wound healing, seroma formation and haematoma were classified as complications. The presence of comorbidities, age over 50 and living donor transplants were identified as significant risk factors for postoperative complications. The most prevalent complications observed were delayed wound healing (21.2%) and infections (16.9%) (p < 0.05). Antibiotics were found to be effective in managing infections, while prolonged conservative management was necessary for delayed wound healing. Prominent complications that recurred were infections and wound healing delays. No statistically significant correlation was observed between gender, BMI and prior transplants with the occurrence of complications (p > 0.05). The research highlighted the significance of taking into account patient-specific variables, including age and concurrent medical conditions, when conducting post-kidney transplantation treatment. The results supported the use of individualized strategies in postoperative care, particularly for populations at high risk, in order to reduce the incidence and severity of complications associated with wounds in pursuit to enhancing clinical practices and formulating focused intervention strategies to improve patient outcomes following transplantation.

摘要

对于终末期肾病患者来说,肾脏移植是一种基本的干预手段。然而,患者的预后受到与术后伤口相关并发症的极大影响。本研究旨在确定肾移植受者与伤口相关并发症的发生率、危险因素和后果。这是一项在中国山东大学齐鲁医院器官移植科进行的横断面观察性研究。研究纳入了在指定时间段内接受肾脏移植的 118 名患者。采用病历评估、问卷调查和患者访谈收集数据,重点关注人口统计学、移植信息、术后护理和伤口并发症。将感染、裂开、淋巴囊肿、伤口愈合延迟、血清肿形成和血肿归类为并发症。存在合并症、年龄超过 50 岁和活体供者移植被确定为术后并发症的显著危险因素。观察到的最常见并发症是伤口愈合延迟(21.2%)和感染(16.9%)(p<0.05)。抗生素被发现对感染有效,而延迟的伤口愈合需要长期保守治疗。复发的突出并发症是感染和伤口愈合延迟。性别、BMI 和既往移植与并发症的发生之间没有观察到统计学上的显著相关性(p>0.05)。研究强调了在进行肾移植后治疗时考虑患者特定变量(包括年龄和并存疾病)的重要性。研究结果支持在术后护理中使用个体化策略,特别是针对高风险人群,以降低与伤口相关的并发症的发生率和严重程度,从而提高临床实践并制定有针对性的干预策略,改善移植后的患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be0f/10961868/91a5e193465f/IWJ-21-e14578-g001.jpg

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