关键词:

肾移植 ；危急值 ；围术期 ,

Abstract:

Objective The aim of this study is to analyze and summarize the markers，characteristics and causes of common critical values in renal transplant recipients during the perioperative period. Methods The data of gender，age，primary disease，transplantation time，critical values，complications and corresponding treatments as well as blood concentrations of immunosuppressive agents after transplantation were collected and analyzed in 283 cases of renal transplant recipients who presented with critical values between January 2018 and November 2020. Results The most common preoperative critical value of renal transplant recipients was highserum creatinine（62.7%，69/110），followed by electrolyte and acid-base disorders（27.3%，30/110）. And the most common postoperative critical value of renal transplant recipients was electrolyte and acid-base disorders（39.9%，69/173），followed by microbial isolation or culture positivity（22.0%，38/173）and abnormal bloodroutine test（15.0%，26/173）. The preoperative and postoperative mean age of patients presented with critical values were（39.3 ±12.5）years old and（45.4 ±11.6）years old（P ＜ 0.001），

respectively. And the ratio of male to female were statistically significant（78.2% vs 21.8% preoperatively and 62.4% vs 37.6% postoperatively，P ＜ 0.05）. Conclusion Renal transplant recipients are in the end stage of renal disease before transplantation，and critical values mostly occur in patients with irregular or inadequate dialysis，as well as in those with irregular follow-up. Therefore，attention should be paid to education and follow-up for the patients waiting for transplantation，to ensure regular dialysis and visits. The early emergence of critical values in renal transplant recipients is mainly dueto the changes of internal environment，electrolyte imbalance caused by polyuria or diuresis，delayed graft function，acute rejection and drug interaction. Therefore，it is necessary to strengthen monitoring and timely adjustment for postoperative patients. 

Key words:

Renal transplant, Critical values, Perioperative period