肾移植术前高压氧治疗对术后低氧血症发生的影响

夏阳; 范明齐; 黄赤兵

doi:10.3969/j.issn.1674-7445.2017.03.010

肾移植术前高压氧治疗对术后低氧血症发生的影响

doi: 10.3969/j.issn.1674-7445.2017.03.010

400038 重庆，第三军医大学新桥医院泌尿外二科

基金项目:

重庆市科技计划项目 cstc2013jcyjA10127

详细信息

通讯作者:
夏阳，Email：12407909@qq.com

中图分类号: R617, R459.6
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- 被引次数: 0
出版历程
- 收稿日期: 2017-01-30
- 网络出版日期: 2021-01-19
- 刊出日期: 2017-05-15

Effect of preoperative hyperbaric oxygen therapy on the incidence of hypoxemia after renal transplantation

Xinqiao Hospital, the Third Military Medical University, Chongqing 400038, China

More Information

Corresponding author: Xia Yang, Email:12407909@qq.com

摘要

摘要: 目的探讨术前实施高压氧治疗对肾移植患者术后低氧血症发生的影响。方法实验组55例肾移植受者术前实施高压氧治疗，对照组66例患者常规实施肾移植术。比较两组患者术后低氧血症发生率、肺部感染率、卧床吸氧时间、住院时间等方面的差异。结果实验组55例患者术后发生低氧血症12例，发生率为22%，对照组66例患者术后发生低氧血症20例，发生率为30%。实验组发生肺部感染4例，发生率为7%，对照组发生肺部感染14例，发生率为21%。实验组肾移植术后低氧血症及肺部感染的发生率低于对照组（均为P < 0.05）。实验组和对照组患者术后卧床吸氧时间分别为（5.9±2.0）d、（6.8±2.6）d，住院时间分别为（17.7±3.7）d、（20.5±4.2）d。实验组患者卧床吸氧时间及住院时间均短于对照组（均为P < 0.05）。结论术前实施高压氧治疗可以明显降低肾移植术后低氧血症及肺部感染的发生率，可以作为肾移植术后低氧血症的常规预防措施。
- 高压氧 /
- 术前 /
- 肾移植 /
- 氧饱和度 /
- 低氧血症 /
- 肺部感染 /
- 卧床吸氧 /
- 住院时间
Abstract: Objective To investigate the effect of preoperative hyperbaric oxygen therapy upon the incidence of hypoxemia in patients after renal transplantation. Methods In the experimental group, 55 patients received hyperbaric oxygen therapy prior to renal transplantation, and 66 counterparts in the control group underwent conventional renal transplantation. Postoperatively, the incidence of hypoxemia, pulmonary infection, time of in-bed oxygen inhalation and length of hospital stay were statistically compared between two groups. Results In the experimental group, 12 among 55 patients (22%) presented with hypoxemia after renal transplantation, and 20 of 66 (30%) in the control group. In the experimental group, 4 cases suffered from pulmonary infection with an incidence of 7%, and 14 (21%) in the control group. In the experimental group, the incidences of hypoxemia and pulmonary infection were lower than those in the control group (both P < 0.05). In the experimental group, the time of in-bed oxygen inhalation and length of hospital stay were (5.9±2.0) d and (17.7±3.7) d, significantly shorter compared with (6.8±2.6) d and (20.5±4.2) d in the control group (both P < 0.05). Conclusions Prior to renal transplantation, hyperbaric oxygen therapy can significantly reduce the risk of hypoxemia and pulmonary infection after renal transplantation, which can be served as a conventional preventive measure against the incidence of hypoxemia following renal transplantation.
- Hyperbaric oxygen therapy /
- Preoperative /
- Renal transplantation /
- Oxygen saturation /
- Hypoxemia /
- Pulmonary infection /
- In-bed oxygen inhalation /
- Length of hospital stay

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参考文献(16)

[1]	王云生, 杨惠标, 张银甫.肾移植患者相关低氧血症的临床研究[J].中国危重病急救医学, 1998, 10(5):293-295. http://kns.cnki.net/KCMS/detail/detail.aspx?dbcode=CJFQ&dbname=CJFD9899&filename=ZWZB805.014&v=MjM1MDVieWVZZWR2RlN2aFd3PT1QenJSYkx1NEc4L01yb3NxRjU0T2ZnZzV6aEFVNGpoNE9YNlRySDAzZWJPVFI= Wang YS, Yang HB, Zhang YP.Clinical research on hypoxemia in patients after renal transplantation [J].Chin Crit Care Med, 1998, 10(5):293-295. http://kns.cnki.net/KCMS/detail/detail.aspx?dbcode=CJFQ&dbname=CJFD9899&filename=ZWZB805.014&v=MjM1MDVieWVZZWR2RlN2aFd3PT1QenJSYkx1NEc4L01yb3NxRjU0T2ZnZzV6aEFVNGpoNE9YNlRySDAzZWJPVFI=
[2]	Shih CJ, Tarng DC, Yang WC, et al.Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia[J].Singapore Med J, 2014, 55(7):372-377. doi: 10.11622/smedj.2014089
[3]	乔丽娟.高压氧综合治疗一氧化碳中毒迟发脑病患者的体会[J].吉林医学, 2014, 35(9):1905. Qiao LJ.Hyperbaric oxygen in the treatment of delayed encephalopathy after carbon monoxide poisoning[J].Jilin Med J, 2014, 35(9):1905.
[4]	周迈, 王宇.术前高压氧治疗对肝硬化门静脉高压症病人的影响[J].中华肝胆外科杂志, 2001, 7(6):338-342.DOI: 10.3760/cma.j.issn.1007-8118.2001.06.006.Zhou M, Wang Y.Effects of preoperative hyperbaric oxygen therapy on patients with hepatic cirrhosis portal hypertension [J].Chin J Hepatobiliary Surg, 2001, 7(6):338-342.DOI: 10.3760/cma.j.issn.1007-8118.2001.06.006.
[5]	谢松林.术前高压氧预处理对颈椎疾病患者神经功能恢复的影响[J].中国实用神经疾病杂志, 2014, 17(22):41-42.DOI: 10.3969/j.issn.1673-5110.2014.22.021.Xie SL.Effects of preoperative hyperbaric oxygen preconditioning on the neurological function recovery of patients with cervical vertebra disease[J].Chin J Pract Nerv Dis, 2014, 17(22):41-42.DOI: 10.3969/j.issn.1673-5110.2014.22.021.
[6]	陈玲珍, 翁其彪, 王宏隽, 等.高压氧综合治疗移植肾功能延迟恢复的临床观察[J].中华航海医学与高气压医学杂志, 2007, 14(2):74-76. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHHH200702007.htm Chen LZ, Weng QB, Wang HJ, et al.The clinical observation of delayed renal graft function with hyperbaric oxygen therapy [J].Chin J Naut Med Hyperbaric Med, 2007, 14(2):74-76. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHHH200702007.htm
[7]	Krowka MJ, Dickson ER, Wiesner RH, et al.A prospective study of pulmonary function and gas exchange following liver transplantation[J].Chest, 1992, 102(4) :1161-1166. doi: 10.1378/chest.102.4.1161
[8]	Mandell LA, Wunderink RG, Anzueto A, et al.Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults[J].Clin Infect Dis, 2007, 44 (Suppl2):S27-S72.DOI: 10.1086/511159.
[9]	许霞, 郭述良.肾移植术后肺部并发症125例临床分析[J].重庆医学, 2015, 44(7):913-915, 918.DOI: 10.3969/j.issn.1671-8348.2015.07.017.Xu X, Guo SL.Pulmonary complications observed in 125 patients with renal transplantation[J].Chongqing Med, 2015, 44(7):913-915, 918.DOI: 10.3969/j.issn.1671-8348.2015.07.017.
[10]	张慧然, 徐金升, 白亚玲, 等.维持性血液透析患者贫血治疗达标情况及影响因素研究[J].中国全科医学, 2016, 19(19):2284-2288.DOI: 10.3969/j.issn.1007-9572.2016.19.012.Zhang HR, Xu JS, Bai YL, et al.Standard-reaching status of anemia treatment of patients with maintenance hemodialysis and the influencing factors [J].Chin Gen Pract, 2016, 19(19): 2284-2288.DOI: 10.3969/j.issn.1007-9572.2016.19.012.
[11]	张剑英, 张雪华.全身麻醉术后低氧血症的临床分析及护理体会[J].中国卫生标准管理, 2016, 7(19) :164-165.DOI: 10.3969/j.issn.1674-9316.2016.19.110.Zhang JY, Zhang XH.Clinical analysis and nursing experience of hypoxemia after general anaesthesia [J].Chin Health Stand Manag, 2016, 7(19):164-165.DOI: 10.3969/j.issn.1674-9316.2016.19.110.
[12]	McGonigle RJ, WallinJD, Shadduck RK, et al.Erythropoietin deficiency and inhibition of erythropoiesis in renal insufficiency [J].Kidney Int, 1984, 25(2):437-444. doi: 10.1038/ki.1984.36
[13]	陈卫国, 周婷婷, 李晓伟, 等.移植肾功能延迟恢复期间并发重症肺部感染的治疗经验[J].器官移植, 2015, 6(4): 240-244.DOI: 10.3969/j.issn.1674-7445.2015.04.007.Zhang WG, Zhou TT, Li XW, et al.Experience of treatment on delayed graft function complicated with severe pulmonary infection[J].Organ Transplant, 2015, 6(4):240-244.DOI: 10.3969/j.issn.1674-7445.2015.04.007.
[14]	李智斌, 张更, 马帅军, 等.3种肺部感染评分系统在肾移植术后肺部感染中的应用价值比较[J].器官移植, 2016, 7(3):196-200.DOI: 10.3969/j.issn.1674-7445.2016.03.007.Li ZB, Zhang G, Ma SJ, et al.Comparison of application value of three pulmonary infection scoring systems in pulmonary infection after renal transplantation[J].Organ Transplant, 2016, 7(3):196-200.DOI: 10.3969/j.issn.1674-7445.2016.03.007.
[15]	张朋朋, 明英姿, 叶啟发. 肾移植术后重症肺部感染患者死亡危险因素分析[J/CD]. 中华移植杂志(电子版), 2016, 10(2): 66-70. DOI: 10.3877/cma.j.issn.1674-3903.2016.02.004.Zhang PP, Ming YZ, Ye QF.Risk factors of mortality in recipients with severe pneumonia after renal transplantation[J/CD].Chin J Transplant (Electr Vers), 2016, 10(2):66-70.DOI:10.3877/cma.j.issn.1674-3903.2016.02.004.
[16]	安海龙, 杨欣刚, 孙玉琳, 等.不同时期高压氧治疗对重型颅脑创伤患者肺部感染的影响[J].中国康复医学杂志, 2014, 29(5):478-480.DOI: 10.3969/j.issn.1001-1242.2014.05.019.An HL, Yang XG, Sun YL, et al.Effects of hyperbaric oxygen therapy on pulmonary infection in patients with severe traumatic brain injury[J].Chin J Rehabil Med, 2014, 29(5): 478-480.DOI: 10.3969/j.issn.1001-1242.2014.05.019.