摘要
目的通过探讨成人首次肝移植术后一年生存率的主要影响因素,以期进一步提高移植手术存活率,改善生存质量。方法选取本中心2005年1月—2012年12月移植受者为研究对象。将术后生存情况分为存活组(术后存活时间≥1年)和死亡组(术后存活时间<1年)。首先进行单因素分析,再把具有统计学差异的因素纳入到Logistic回归进行分析。结果288例受者中,1年内死亡51例,术后1年存活率82.3%。单因素分析中术中失血量>1500 mL、术后感染、肝肾综合征和移植肝原发无功能差异有统计学意义。纳入Logistic回归分析后,结果显示肝肾综合征(OR=7.272、P<0.001)、术中失血量>1500 mL(OR=5.322,P=0.008)、移植肝原发无功能(OR=19.381,P=0.011)和术后感染(OR=2.245,P=0.024)均是影响移植术后一年生存率的主要相关因素。结论影响受者术后一年生存率的相关因素包括肝肾综合征、术中失血量、移植肝原发无功能和术后感染。及时纠正肝肾综合征、系统性维护肾脏功能,减少术中失血,确保供肝质量,积极防治术后感染,将有助于提高肝移植受者术后一年生存率。
Objective To further improve the survival rate of liver transplantation and improve the quality of postoperative survival,the main factors influencing 1-year survival rate after adult first liver transplantation were discussed.Method Liver transplantation recipients were selected as study objects between January 2005 and December 2012.Postoperative survival was divided into survival group(postoperative survival time≥1 year)and death group(postoperative survival time<1 year).Relevant factors were selected for univariate analysis,and those with statistically significant differences were included in Logistic regression analysis.Results Of the 288 recipients,51 died within 1 year,and the 1-year survival rate was 82.3%.In univariate analysis,there were statistically significant differences in intraoperative blood loss>1500 mL,postoperative infection,hepatorenal syndrome and primary nonfunction.In Logistic regression analysis,hepatorenal syndrome(OR=7.272,P<0.001),intraoperative blood loss>1500 mL(OR=5.322,P=0.008),primary nonfunction(OR=19.381,P=0.011)and postoperative infection(OR=2.245,P=0.024)were the main factors affecting 1-year survival after liver transplantation.Conclusion Factors affecting 1-year survival after surgery include hepatorenal syndrome,intraoperative blood loss,primary nonfunction and postoperative infection.Timely correction of hepatorenal syndrome,systematic maintenance of renal function,reduction of intraoperative blood loss,to ensure the quality of donor liver,and active prevention and treatment of postoperative infection will help improve the one-year survival rate of liver transplantation recipients.
作者
伊展
刘爱萍
YI Zhan;LIU Aiping(School of Public Health,Peking University,Beijing 100191,China)
出处
《中国继续医学教育》
2020年第1期108-111,共4页
China Continuing Medical Education
关键词
肝移植
生存率
相关因素
预后
肝肾综合征
术后感染
liver transplantation
survival rates
related factor
prognosis
HRS
postoperative infection
