肺移植患者移植后糖尿病的影响因素分析及护理启示

doi:10.3761/j.issn.0254-1769.2024.16.010

摘要/Abstract

摘要：

目的研究成人肺移植患者移植后糖尿病（post-transplant diabetes mellitus，PTDM）的发生情况及其影响因素。方法采取便利抽样法，回顾性分析浙江省杭州市某三级甲等综合医院肺移植科2020年1月—2022年12月肺移植患者的临床资料。根据PTDM诊断标准，将肺移植患者分为PTDM组与非PTDM组，统计PTDM发生率，采用单因素及多因素Logistic回归方法分析发生PTDM的影响因素。结果共纳入140例患者，肺移植患者6个月内发生PTDM共54例，发生率为38.57%。单因素分析显示，两组年龄、性别、BMI、吸烟史、术前糖化白蛋白、术前空腹血糖、术后早期血糖、术前肌酐比较，差异具有统计学意义（P<0.05）。Logistic回归分析显示，性别（OR=5.283）、BMI（OR=6.122）、术前糖化白蛋白（OR=1.330）、术后早期血糖（OR=1.444）是其影响因素。结论男性、BMI≥24.0、术前糖化白蛋白高、术后早期血糖高的肺移植患者发生PTDM的风险更高。临床护理人员可根据影响因素制订相关护理措施，预防PTDM的发生。

关键词: 肺移植, 移植后糖尿病, 影响因素分析, 护理

Abstract:

Objective To investigate the incidence and risk factors of post-transplant diabetes mellitus（PTDM） in adult lung transplant recipients. Methods Conducting a convenience sampling method，we retrospectively analyzed the clinical data of lung transplant recipients from January 2020 to December 2022 at a tertiary A hospital in Hangzhou，Zhejiang Province. According to the PTDM diagnostic criteria，lung transplant recipients are divided into a PTDM group and a non-PTDM group. The incidence rate of PTDM is calculated，and the influencing factors for PTDM occurrence are analyzed using both univariate and multivariate logistic regression methods. Results A total of 140 patients were included in this study，and 54 lung transplant recipients developed PTDM within 6 months，with an incidence of 38.57%. Univariate analysis showed that there were significant differences in age，gender，BMI，smoking history，pre-operative glycated albumin，pre-operative fasting blood glucose，early post-operative blood glucose and pre-operative creatinine between the 2 groups（P<0.05）. Multivariate Logistic analysis showed that gender （OR=5.283），BMI（OR=6.122），pre-operative glycated albumin（OR=1.330），and early post-operative blood glucose（OR=1.444） were the influencing factors. Conclusion Lung transplant recipients who were male，BMI≥24.0，with high levels of glycated albumin before surgery，and high blood sugar early after surgery had a higher risk of developing PTDM. Clinical nurses can formulate relevant nursing measures according to the influencing factors to prevent the occurrence of PTDM.

Key words: Lung Transplantation, Post-Transplant Diabetes Mellitus, Root Cause Analysis, Nursing Care

蔡凌云, 曾妃, 郭璐瑶, 兰美娟, 梁江淑渊, 顾培培, 朱岩, 郭鸽. 肺移植患者移植后糖尿病的影响因素分析及护理启示[J]. 中华护理杂志, 2024, 59(16): 1987-1992.

CAI Lingyun, ZENG Fei, GUO Luyao, LAN Meijuan, LIANG Jiangshuyuan, GU Peipei, ZHU Yan, GUO Ge. Analysis and nursing enlightenment of influencing factors of post-transplant diabetes mellitus in lung transplant recipients[J]. Chinese Journal of Nursing, 2024, 59(16): 1987-1992.

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