摘要
目的探讨肝移植围手术期的危险因素与术后肺部并发症的关系。方法回顾性分析我院2003年4月至2007年3月行肝移植手术的终末期肝病患者107例,单因素兼多因素Lo-gistic回归分析患者术前、术中和术后的一些因素与肝移植术后肺部并发症情况的相关性。结果本研究所有患者的肺部并发症发生率为60.8。术前Meld评分≥25分(P=0.041),术中输液总量>10L(P=0.026),输血液制品总量>4L(P=0.033)是术后发生肺部并发症的危险因素,而术后前3d至少有2d的液体平衡≤-300ml(P=0.021)是保护因素。结论肝移植术前改善基础状况,术中控制输液量、减少输血液制品量,术后尽早实现液体出入量的负平衡可减少术后肺部并发症的发生率。
Objective To approach the relations between perioperative risk factors of liver transplantation and postoperative pulmonary complications. Methods 107 patients with end - stage liver disease under liver transplantation between April 2003 and March 2007 were analyzed retrospectively in our hospital. Mono - factorial and multivariate logistic regression analysis was used to investigate the correlation of some perioperative risk factors and pulmonary complications after liver transplantation. Results The total incidence of patient＇s pulmonary complications was 60.8% in this research. Meld score ≥25 （P =0.041 ）, the total amount of the intraoperative transfusion 〉 10 L（ P = 0. 026）, the total amount of blood products - transfusion 〉 4 L（ P = 0. 033 ） were risk factors leading to pulmonary complication, while fluid balance（ ≤ - 300 ml） （P = 0.021 ） in ≥2 days of the first 3 days after operation was a protective factor. Conclusion Improving basal conditions before liver transplantation, controlling the amount of the intraoperative transfusion, reducing the amount of blood products - transfusion and implementing the negative balance of liquid intake and output volume as soon as possible could reduce the incidence of pulmonary complications.
出处
《临床外科杂志》
2008年第12期808-810,共3页
Journal of Clinical Surgery
基金
全军十一五杰出人才项目(06J007)
关键词
肝移植术
肺部并发症
危险因素
transplantation of liver
pulmonary complications
risk factors
