肝移植围手术期并发症的处理  

The management of perioperative complication inliver transplantation

作　　者：李志强[1] 臧运金[1] 郭源[1] 杨光文[1] 于振海[1] 沈中阳[2] 

机构地区：[1]山东省千佛山医院,山东济南250014 [2]天津第一中心医院

出　　处：《山东医药》2005年第18期16-17,共2页Shandong Medical Journal

基　　金：山东省科技厅科学技术发展计划项目(No.2002BB1DCA1)

摘　　要：目的探讨肝移植围手术期并发症的发生规律及处理方法。方法回顾性分析44例肝移植病例的并发症及处理。结果32例发生肺部细菌性感染(72%),其中13例合并真菌感染(29.5%),死亡2例(15.3%);急性肾功能不全(ARF)9例(20.4%),7例须连续肾脏替代(CRRT)治疗,死亡3例(33.3%);大量胸腔积液14例(31.8%),无死亡;急性排斥反应5例(11.3%),无死亡;腹腔内出血5例(11.3%),死亡2例(40%);胸腔内出血2例(4.5%),无死亡;T管脱出2例(4.5%),死亡1例(50%)。结论肝移植围手术期死亡主要与并发症有关,早期诊断与处理并发症,是提高肝移植存活率的重要措施。Objective To summarize the management of perioperative complication in orthotopic liver transplantation (OLTx).Methods The complication and the management in 44 cases of OLTx were analyized.Results Thirty (72%)patients suffercd from bacterial lung infection and 13(29.5%)patients combined with fungal infection,2(15.4%)patients were died.Acute renal failure(ARF)occurred in 9(9/44,20.4%)patients,7 patients underwent continuous renal replacement therapy (CRRT),3(3/9,33.3%)patients died.Mass of thoracic ascites in 14 (14/44,31.8%)patients.Acute rejection in 5 (5/44,11.3%) patients.5 (5/44,11.3%)patients occurred perioperative abdominal bleeding,2 (2/5,40%)patients died and 2 patients(2/44,4.5%)occurred thoracic bleeding.T type tube was pulled out in 2 patients(2/44,4.5%)and 1 died of abdominal infection.Conclusion The perioperative complication is a cause of mortality in OLTx.Early diagnosis and management of the complication is a major way to improve perioperative survival in OLTx.

关 键 词：肝移植 围手术期 并发症 减体积式移植术 血液动力学 

分 类 号：R657.3[医药卫生—外科学]