尸体肾移植受者术后围术期腹泻的影响因素分析

袁智辉; 杨麒臻; 贾磊; 晁晟; 徐媛; 潘光辉; 牛玉林

doi:10.16016/j.2097-0927.202211186

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尸体肾移植受者术后围术期腹泻的影响因素分析

临床医学 | 更新时间：2026-01-09

- 尸体肾移植受者术后围术期腹泻的影响因素分析
- Influencing factors for perioperative diarrhea in recipients after deceased-donor kidney transplant
- 陆军军医大学学报 2023年45卷第14期页码：1556-1561
- 作者机构：
  
  550004 贵阳，贵州医科大学附属医院器官移植科
- 作者简介：
  
  [ 牛玉林，E-mail: nniuyulin@163.com NIU Yulin, E-mail: nniuyulin@163.com
- 基金信息：
  
  黔科合基础-ZK[2023]一般380
- DOI：10.16016/j.2097-0927.202211186
  中图分类号： R442.2;R617;R692
- 收稿：2022-11-14，
  
  修回：2023-01-04，
  
  纸质出版：2023-07-30
- 稿件说明：
移动端阅览
袁智辉, 杨麒臻, 贾磊, 等. 尸体肾移植受者术后围术期腹泻的影响因素分析[J]. 陆军军医大学学报, 2023,45(14):1556-1561.

Zhihui YUAN, Qizhen YANG, Lei JIA, et al. Influencing factors for perioperative diarrhea in recipients after deceased-donor kidney transplant[J]. Journal of Army Medical University, 2023, 45(14): 1556-1561.
袁智辉, 杨麒臻, 贾磊, 等. 尸体肾移植受者术后围术期腹泻的影响因素分析[J]. 陆军军医大学学报, 2023,45(14):1556-1561. DOI： 10.16016/j.2097-0927.202211186.

Zhihui YUAN, Qizhen YANG, Lei JIA, et al. Influencing factors for perioperative diarrhea in recipients after deceased-donor kidney transplant[J]. Journal of Army Medical University, 2023, 45(14): 1556-1561. DOI： 10.16016/j.2097-0927.202211186.

摘要

目的

探讨导致尸体肾移植受者术后围术期腹泻的相关因素。

方法

采用病例-对照研究设计方案，收集2017年7月至2021年12月贵州医科大学附属医院器官移植科545例尸体肾移植受者围术期的临床资料，分为腹泻组(207例)和非腹泻组(338例)，统计对比两组受者年龄、性别、体质指数(body mass index

BMI)、手术时间、透析方式、是否患有2型糖尿病、免疫诱导方案、霉酚酸(mycophenolic acid，MPA)种类、预防感染方案、术前灌肠、移植肾功能延迟恢复(delayed graft function，DGF)发生情况等。采用多因素Logistic逐步回归分析与尸体肾移植术后围术期腹泻相关的因素。

结果

尸体肾移植术后围术期腹泻发生率为37.98%(207/545)，腹泻组受者腹泻发生时间为移植后(5.90±6.94)d，其中腹泻发生在3 d内的患者占71.98%(149/207)。单因素分析结果显示：年龄、性别、BMI、2型糖尿病、免疫诱导方案、抗生素预防感染方案、术前灌肠、术后发生DGF差异均有统计学意义。多因素Logistic逐步回归分析结果显示：超重患者(

=1.074，95%

: 1.011~1.141)、性别为男性(

=1.596，95%

: 1.032~2.470)、术后发生DGF(

=3.001，95%

: 1.712~5.260)、哌拉西林钠他唑巴坦钠的预防感染方案(

=3.119，95%

: 1.918~5.074)是尸体肾移植受者发生围术期腹泻的独立危险因素。

结论

超重、男性、移植后发生DGF、使用哌拉西林钠他唑巴坦钠作为预防感染方案可能是尸体肾移植受者在围术期发生腹泻的风险因素。

Abstract

Objective

To explore the related factors of perioperative diarrhea in cadaveric renal transplant recipients.

Methods

A case-control trial was conducted on 545 recipients receiving cadaveric renal transplantation in the Affiliated Hospital of Guizhou Medical University from July 2017 to December 2021. Their clinical data during perioperative period were collected

and then all recipients were divided into the diarrhea group (

=207) and non-diarrhea group (

=338). Their age

gender

body mass index (BMI)

duration of operation

dialysis types

type 2 diabetes or not

immune induction regimen

mycophenolic acid (MPA) types

infection prevention regimen

preoperative enema

and occurrence of delayed graft function (DGF) were observed and recorded. Multivariate stepwise logistic regression analysis was used to analyze the factors related to the perioperative diarrhea in these recipients.

Results

The incidence of perioperative diarrhea was 37.98% (207/545). The occurrence time of diarrhea was in 5.90±6.94 d after transplantation

and 71.98% (149/207) of diarrheal patients occurred within 3 d. Univariate analysis showed that significant differences were observed in age

gender

BMI

type 2 diabetes

immune induction

regimen

antibiotic prevention regimen

preoperative enema

and post-operative DGF occurrence between the diarrhea and non-diarrhea groups. Multivariate stepwise logistic regression analysis indicated that overweight(

=1.074

95%

: 1.011~1.141)

male (

=1.596

95%

: 1.032~2.470)

post-operative DGF (

=3.001

95%

: 1.712~5.260) and use of piperacillin after transplantation (

=3.119

95%

: 1.918~5.074) were independent risk factors for perioperative diarrhea in cadaveric kidney transplant recipients.

Conclusion

Overweight

male

DGF and piperacillin use after transplantation may be the risk factors of perioperative diarrhea in cadaveric transplant recipients.

关键词

Keywords

references

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