Đánh giá kết quả hồi sức sau ghép thận ở trẻ em tại Bệnh viện Nhi trung ương

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Ánh Dương Đặng, Đức Thường Nguyễn, Vãn Thuận Nguyễn, Hồng Sơn Phạm

Ngôn ngữ: Vie

Ký hiệu phân loại: 618.92 Pediatrics

Thông tin xuất bản: Nhi khoa 2023

Mô tả vật lý: 41-49

Bộ sưu tập: Metadata

ID: 398590

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Mô tả diễn biến lâm sàng, xét nghiệm và đánh giá các biến chứng sớm sau giai đoạn hồi sức sau phẫu thuật ghép thận.Đối tượng và phương pháp nghiên cứu: nghiên cứu cắt ngang mô tả tiến hành tại Khoa Điều trị tích cực Ngoại khoa Bệnh viện Nhi Trung ương. Dữ liệu và hổ sơ bệnh án của bệnh nhân sau ghép thận được thu thập từ tháng 1/2014 đến 4/2022.Kết quả: Nghiên cứu bao gỏm 33 bệnh nhân với tuồi trung bình là 11,1 ± 3,3 tuổi trong đó 70% bệnh nhân là nam, cân nặng trung bình IÒ28+ 10 kg. Thời gian thở máy trung vị là 6,1 giờ (IQR 4,0 - 12,3). 53,3% bệnh nhân cần sử dụng thuốc vận mạch/tăng co bóp cơ tim. Tăng huyết áp gặp trên 22 bệnh nhân (73,3%) trong số đó 19/22 cần dùng các thuốc hạ áp đường tĩnh mạch. Đa niệu xuất hiện ngay sau mổ và giảm dần sau mổ, nồng độ ure và creatinine về bình thường sau 3 ngày. 9 bệnh nhân (30%) ghi nhận biến chứng trong giai đoạn hổi sức trong đó chảy máu sau mổ hay gặp nhất (4/33 bệnh nhân) sau đó là nhiễm khuẩn tiết niệu (3/33 bệnh nhân). Biến chứng chậm chức năng khối ghép và hẹp động mạch thận gặp ở 1 bệnh nhân (1/33 bệnh nhân).Kết luận: Phẫu thuật ghép thận ở trẻ em trong giai đoạn sớm sau mổ có tỷ lệ biến chứng cao. Theo dõi lâm sàng liên tục là cần thiết đề phát hiện và điều trị sớm các biến chứng này., Tóm tắt tiếng anh, We conducted a descriptive cross-sectional study in the Surgical intensive care unit of the Vietnam National Children's Hospital. Data of patients underwent renal transplant procedure were collected from January 2014 to April 2022.Results:The study included 33 patients with an average age of 11.1 ± 3.3 years, of which 70% were male, the average weight of them was 28 ± 10 kg. The median mechanical ventilation timewas 6.1 hours (IQR 4.0-12.3). 53.3% of patients required vasopressors/inotropes. Hypertension was documented in 22 patients (73.3%)
of which, 19/22 required intravenous antihypertensive drugs. Polyuria gradually improve after surgery, urea and creatinine levels turned to normal after 3 days. 9 patients (30%) reported complications in which postoperative bleeding was the most common cause (4/33 patients) followed by urinary tract infection (3/33 patients). Only one case of delayed graft function and one case of renal artery stenosis were observed.Conclusion: A high incidence of perioperative complications after kidney transplant surgery was documented. Continuous postoperative clinical monitoring is imperative for early detection and treatment of these complications.

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