摘要
目的探究肾移植受者术前内脏脂肪厚度对手术难度及术后并发症的影响。方法回顾性纳入2020年1月—2022年1月于首都医科大学附属北京友谊医院行同种异体肾移植手术的终末期肾病患者共179例。按患者移植前CT下测量内脏脂肪厚度(脐上1 cm水平腹主动脉前壁至壁腹膜的距离),分为薄内脏脂肪组(内脏脂肪厚度≤7.5 cm,n=103)和厚内脏脂肪组(内脏脂肪厚度>7.5 cm,n=76)。分析并对比两组患者肾移植术前流行病学资料、肾移植手术时间、术中出血量、术后并发症情况、移植后肾功能及患者恢复情况。计量资料以均数±标准差(±s)表示,组间比较采用独立样本t检验;计数资料组间比较采用χ^(2)检验。结果薄内脏脂肪组患者平均年龄及体重指数分别为(38.70±11.50)岁及(21.28±2.93) kg/m^(2),均低于厚内脏脂肪组的(43.14±11.42)岁和(24.78±3.37) kg/m^(2),且差异具有统计学意义(P<0.05),而其余术前流行病学资料两组间差异无统计学意义(P>0.05)。在手术难度方面,薄内脏脂肪组患者的平均手术时间为(117.16±34.33) min,明显短于厚内脏脂肪组的(137.11±20.02) min;薄内脏脂肪组患者的平均术中出血量为(89.12±45.95) mL,也少于厚内脏脂肪组的(125.39±54.88) mL;差异均具有统计学意义(P<0.001)。在术后并发症方面,薄内脏脂肪组中共41患者出现术后感染、切口疼痛、术区积液等并发症,其发生率为39.8%(41/103),显著低于厚内脏脂肪组的78.9%(60/76),差异具有统计学意义(P<0.001);但两组间Clavien-Dindo 3级以上的严重并发症发生率差异无统计学意义(P>0.05)。在移植肾功能恢复方面,两组患者术后第3、5、7天及第1、2个月血肌酐水平差异均无统计学意义(P>0.05)。但随访至术后第3个月时,薄内脏脂肪组患者的平均血肌酐水平为(116.06±36.45) μmol/L,低于厚内脏脂肪组的(133.35±72.26) μmol/L,且差异具有统计学意义(P=0.038)。两组患者�
Objective To investigate the effect of visceral fat thickness before operation on the operative difficulty and postoperative complications in renal transplantation recipients.Methods A total of 179 patients diagnosed with end-stage renal disease who underwent kidney transplantation in Beijing Friendship Hospital,Capital Medical University from January 2020 to January 2022 were retrospectively included.According to the visceral fat thickness measured by CT before transplantation(distance from anterior wall of abdominal aorta to parietal peritoneum at 1 cm above umbilicus),patients were divided into two groups,with 103 patients in thin visceral fat group with visceral fat thickness≤7.5 cm and 76 patients in thick visceral fat group with visceral fat thickness>7.5 cm.The epidemiological data before renal transplantation,operative time,intraoperative blood loss,postoperative complications,renal function after transplantation and patients′recovery state were analyzed and compared between the two groups.Measurement data were expressed as mean±standard deviation(±s),and independent sample t-test was used for comparison between groups.The Chi-square test was used to compare the count data.Results The mean age and body mass index of patients in thin visceral fat group[(38.70±11.50)years and(21.28±2.93)kg/m^(2)]were lower than those in thick visceral fat group[(43.14±11.42)years and(24.78±3.37)kg/m^(2)],and the differences were statistically significant(P<0.05).There was no significant difference in other preoperative epidemiological data between the two groups(P>0.05).In terms of operation difficulty,the mean operation time of thin visceral fat group was(117.16±34.33)min,which was significantly shorter than that of thick visceral fat group(137.11±20.02)min.The mean intraoperative blood loss in the thin visceral fat group was(89.12±45.95)mL,which was lower than that in the thick visceral fat group(125.39±54.88)mL,the differences were statistically significant(P<0.001).In terms of postoperative complications,4
作者
吕竟成
侯雨时
田野
郭宇文
张磊
朱一辰
Lyu Jingcheng;Hou Yushi;Tian Ye;Guo Yuwen;Zhang Lei;Zhu Yichen(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《国际外科学杂志》
2024年第2期91-96,共6页
International Journal of Surgery
关键词
肾移植
手术后并发症
内脏脂肪
Kidney transplantation
Postoperative complications
Visceral fat
