老年肾移植27例临床分析与护理对策

目的:探讨60岁以上老年肾移植患者的临床特点及护理措施。方法:回顾性分析超过60岁肾移植患者27例临床资料,并以同期小于60岁的肾移植患者144例作对照。结果:老年患者透析时间长,低蛋白血症严重,冠心病、糖尿病及心力衰竭发病率高,与对照组比较,差异有显著性(P<0.05)。老年组术后肺部感染、肝功能损害、心力衰竭、心绞痛及糖尿病等的发病率均高于对照组(P<0.05)。结论:老年患者进行肾移植时,术前应慎重选择、充分准备、严格配型,术后合理使用免疫抑制剂,严格消毒隔离制度,加强基础护理,严密观察生命体征,积极处理并发症,以提高移植肾成活率。

Clinical analysis and nursing of 27 elderly patients operated by renal transplantation

Objective: To explore the clinical features and nursing of the elderly patients over 60 with renal transplantation. Methods: Retrospective analysis was done in 27 elderly patients over 60 and compared the conditions of the corresponding period with 144 patients below 60 operated by renal transplantation. Results: For the elderly patients, dialysis took longer, hypoproteinemia was serious, and the sick rate of coronary heart disease, diabetes and heart failure were higher. Significant difference was shown (P<0.01). The occurrence of postoperative pulmonary infection, damage of liver function, heart failure, angina pectoris and diabetes are higher than that in the control group (P<0.05). Conclusion: Full preparation should be made before operation of renal transplantation on elderly patients, such as prudent selection of cases, strict matching, strict disinfection, strict isolation, proper use of immunosuppressant, strengthened fundamental nursing, close monitoring of vital signs and prompt treatment of complication, to increase survival rate of donor's kidney.