论文部分内容阅读
【目的】总结中山大学附属第一医院肾移植专科重新组建前后两个阶段肾移植经验。【方法】1972年12月至2004年4月,我院共行肾移植2562例,根据肾移植专科组建和发展情况,以手术时间1998年1月为界将其分为A组(n=1318)和B组(n=1244),比较两个阶段的肾移植效果。【结果】超急性排斥21例:A组17例(1.3%)、B组4例(0.3%)(P<0.01=0.0066);加速排斥61例:A组50例(3.8%)、B组11例(0.9%)(P<0.001);急性排斥298例:A组208例(15.8%)、B组90例(7.2%)(P<0.001);两组各种排斥发生率差异均有统计学意义(P<0.001)。血管并发症51例:A组37例(2.8%)、B组14例(1.1%)(P<0.01=0.0023);输尿管梗阻30例:A组21例(1.6%)、B组9例(0.7%)(P<0.05=0.0408);切口感染130例:A组99例(7.5%),B组31例(2.5%)(P<0.001);肺部感染144例:A组79例(6.0%),其中死亡34例(43%),B组65例(5.2%),死亡18例(27.7%);两组肺部感染死亡率差异具有统计学意义(P<0.05=0.0421)。A、B两组1年人/肾存活率分别为90.0%/87.2%、97.6%/95.0%,3年人/肾存活率分别为86.1%/84.0%、89.2%/86.1%。【结论】我院肾移植外科技术已日益成熟,良好的组织配型及新型免疫抑制剂的应用,减少了排斥反应及其它并发症的发生,是取得良好肾移植效果的保证。高龄、儿童、下尿路异常等患者肾移植的成
【Objective】 To summarize the experience of renal transplantation in two stages before and after the reorganization of kidney transplantations in the First Affiliated Hospital of Sun Yat-sen University. 【Methods】 From December 1972 to April 2004, 2562 renal transplant recipients in our hospital were divided into group A (n = 1318) according to the establishment and development of kidney transplantation specialist in January 1998. ) And group B (n = 1244). The effects of two stages of renal transplantation were compared. 【Results】 Twenty-one cases were hyperacutely rejected (group A, 17 cases, 1.3%) and group B (0.3%, P <0.01 = 0.0066) 11 cases (0.9%) (P <0.001); 298 cases of acute rejection: 208 cases (15.8%) in group A and 90 cases (7.2%) in group B Statistical significance (P <0.001). There were 51 cases of vascular complications, including 37 cases in group A (2.8%) and 14 cases (1.1%) in group B (P <0.01 = 0.0023) (P <0.05). There were 130 cases with incision infection: 99 cases (7.5%) in group A, 31 cases (2.5%) in group B (P <0.05 = 0.0421). There were 34 deaths (43%) in group B, 65 (5.2%) in group B, and 18 deaths (27.7%) in group B. The mortality of pulmonary infection in the two groups was statistically significant (P <0.05 = 0.0421). The 1-year human / kidney survival rates in groups A and B were 90.0% / 87.2% and 97.6% / 95.0%, respectively. The 3-year human / kidney survival rates were 86.1% / 84.0% and 89.2% / 86.1%, respectively. 【Conclusion】 The surgical technique of renal transplantation in our hospital has become more and more mature. The application of good tissue matching and new immunosuppressive agents can reduce the incidence of rejection and other complications, which is the guarantee of good renal transplantation. Elderly, children, lower urinary tract abnormalities such as kidney transplantation into