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肾移植患者的择期手术和急诊手术。

Elective and emergency surgery in renal transplant patients.

作者信息

Leapman S B, Vidne B A, Butt K M, Kountz S L

出版信息

Ann Surg. 1976 Mar;183(3):266-70. doi: 10.1097/00000658-197603000-00009.

Abstract

Additional operations were necessary in 67 (41%) of 162 renal allograft patients. General anesthesia was employed in all but 5 patients with no morbidity or mortality. All patients were immunosuppressed and no additional steroids were used before, during, or after the procedure. The source of the donor kidney made no difference in predicting if a recipient would require post-transplantation surgery or if an emergency or elective operation was required. Oerations were necessary to correct complications either directly related to the transplant procedure (71%), or medical problems of immunosuppression or uremia (21%). Nine patients (6%) required operations unrelated to transplantation. The data indicate that transplant patients frequently need additional procedures which are directly related to the transplant operation, immunosuppression, or metabolic alterations of their past uremic condition. Mortality is related to the degree of toxicity from the immunosuppressive therapy.

摘要

162例肾移植患者中有67例(41%)需要进行额外手术。除5例患者外,其余所有患者均采用全身麻醉,且无 morbidity 或 mortality。所有患者均接受免疫抑制治疗,手术前、手术期间或手术后均未使用额外的类固醇。供体肾的来源对于预测受体是否需要移植后手术或是否需要急诊或择期手术并无差异。手术用于纠正与移植手术直接相关的并发症(71%),或免疫抑制或尿毒症的医疗问题(21%)。9例患者(6%)需要进行与移植无关的手术。数据表明,移植患者经常需要进行与移植手术、免疫抑制或既往尿毒症状态的代谢改变直接相关的额外手术。死亡率与免疫抑制治疗的毒性程度相关。 (注:“morbidity”和“mortality”在医学语境中分别常表示“发病率”和“死亡率”,这里直接保留英文未翻译,因为在专业医学文献中有时会保留英文术语,具体含义需结合上下文确定。)

引用本文的文献

1
Cerebromeningitis in immunosuppressed recipients of renal allografts.
Ann Surg. 1982 Jan;195(1):104-9. doi: 10.1097/00000658-198201001-00015.
2
3
Gastrointestinal complications of hepatic transplantation.
Transplant Proc. 1979 Mar;11(1):257-61.
4
Gastrointestinal complications of renal transplantation. 2. The colon.
Can Med Assoc J. 1978 Dec 9;119(11):1301-5, 1309.
5
Surgical management of complications of steroid therapy.
Ann Surg. 1977 Mar;185(3):251-63. doi: 10.1097/00000658-197703000-00001.

本文引用的文献

1
Adrenocortical steroid therapy resulting in unusual gastrointestinal complications.
AMA Arch Surg. 1959 Aug;79(2):346-56. doi: 10.1001/archsurg.1959.04320080182021.
2
General surgical complications associated with renal allotransplantation using related donors.
Am J Surg. 1967 Aug;114(2):274-8. doi: 10.1016/0002-9610(67)90383-2.
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Emergencies associated with clinical renal transplantation.
Surg Clin North Am. 1966 Jun;46(3):713-26. doi: 10.1016/s0039-6109(16)37894-x.
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Experience with elective surgery in renal allograft recipients.
Am J Surg. 1974 Jun;127(6):730-2. doi: 10.1016/0002-9610(74)90358-4.
6
Acute pancreatitis and hyperamylasemia in renal homograft recipients.
Arch Surg. 1972 Aug;105(2):167-72. doi: 10.1001/archsurg.1972.04180080021004.

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