肝移植术后早期并发症的诊治(附44例报告)  

Diagnosis and treatment of postoperative early complications following liver transplantation in 44 cases

作　　者：阳文新[1] 钟正江[1] 申红[1] 承晓梅[1] 马建新[1] 王轩[2] 许正昌[2] 张斌[2] 李增才[2] 陆雷[2] 

机构地区：[1]解放军第81医院ICU,江苏南京210002 [2]解放军第81医院肝移植中心,江苏南京210002

出　　处：《东南国防医药》2005年第3期169-171,207,共4页Military Medical Journal of Southeast China

摘　　要：目的　总结和探讨肝移植患者术后早期常见并发症的防治经验。方法　回顾性分析4 4例肝移植患者术后早期并发症以及对各种并发症治疗的资料。结果　术后并发症包括:1腹腔内出血4例;2急性排斥反应4例;3胆漏2例;4下腔静脉血栓形成1例;5移植肝原发性无功能(PNF) 1例;6呼吸系统并发症:肺部感染9例,肺不张3例,胸腔积液15例,呼吸衰竭2例;7急性肾功能不全10例;8心血管并发症:窦性心动过缓3例,顽固性高血压1例,严重低血压1例;9神经系统并发症:脑桥中央髓鞘溶解症(CPM) 3例,肝移植后脑病5例;10其他并发症:多器官功能衰竭(MOF) 3例,粒细胞减少症3例,腹腔淋巴管漏2例。均给予了相应治疗。结论　肝移植患者术后应积极预防各种并发症的发生,对肝移植术后并发症的及时诊断和有效治疗能显著提高患者存活率及生活质量。Objective To summarize and explore the prevention and treatment of postoperative early complications after liver transplantation. Methods Causation and treatment of postoperative complications of liver transplantation in 44 cases were retrospectively analyzed .Results Postoperative complications included:①intraabdominal bleeding 4 cases;②acute rejection 4 cases;③bile leaks 2 cases;④lower vena cava thrombosis 1 case;⑤primary nonfunction of transplanted liver 1 case;⑥complications of the respiratory system: pneumonia 9 cases, atelectasis 3 cases, hydrothorax 15 cases, respiratory failure 2 cases; ⑦acute renal function insufficiency 10 cases;⑧complications of cardiovascular system: bradycardia 3 cases, pertinacious hypertension 1 cases, severe hypotension 1 case;⑨complications of the nervous system: central pontine myelinolysis 3 cases, cerebropathy after transplantation 5 cases;10other complications: multiple system organ failure 3 cases, granulocytopenia 3 cases, celiac lymphangial leaks 2 cases. Above all, corresponding treatments were given.Conclusions The results indicate that timely diagnosis and efficacious treatment can enhance livability and live quality of patients after liver transplantation.

关 键 词：肝移植 术后并发症 Z5 z7 

分 类 号：R657.3[医药卫生—外科学]