摘要
目的分析原位肝移植术后早期发生急性肺损伤（ALI）的危险因素，为临床治疗提供参考。方法回顾性分析275例原位肝移植患者围手术期的临床资料，并将患者分为ALI组和非ALI组，以单因素分析筛选出有统计学意义的危险因素，多元逐步Logistic回归分析确定ALI的独立危险因素。结果275例肝移植患者ALI的发生率为9．8％（27／275），总死亡率10．2％（28／275），ALI病死率22．2％（6／27）。Logistic回归分析筛选出术中大量输血（OR=12．12，95％CI 0．958～25．364）、无肝期过长（OR=1．23，95％CI 1．034～1．410）和冷缺血时间过长（OR=22．35，95％CI 1．266～43．421）为原位肝移植术后发生ALI的独立危险因素。结论原位肝移植术后早期发生ALI与大量输血、无肝期过长、冷缺血时间过长关系密切。
Objective To determine the risk factors for acute lung injury（ALI） early after orthotopic liver transplantation.Methods The perioperative clinical data of all 275 patients who had undergone orthotopic liver transplantation were analysed retrospectively. Several statistically significant risk factors were screened out with univarite analysis, then independent risk factors were determined with multivariate stepwise logistic regression analysis. Results Of the all 275 patients, the morbidity of ALI was 9.8 % with a mortality of 22.2 %. Univariate analysis showed that the occurrence of ALI was associated with preoperative infection, severe hepatitis, renal dysfunction, massive blood transfusion in operation, long non-hepatic period and long cold ischemic time. Multivarite stepwise logistic regression analysis revealed that the independent risk factors for ALI were massive blood transfusion in operation（ OR = 12.12,95% CI 0.958-25.364）,longer non-hepatic period（ OR = 1.23, 95% CI 1.034-1.410） and longer cold ischemic time （ OR = 22.35, 95% CI 1.266-43.421 ）. Conclusion Massive blood transfusion in operation, long non-hepatic period and long cold ischemic time were independent risk factors for ALl early after orthotopic liver transplantation.
出处
《中国呼吸与危重监护杂志》
CAS
2007年第3期194-196,212,共4页
Chinese Journal of Respiratory and Critical Care Medicine
