门静脉高压症联合手术后患者发热的危险因素研究  

Risk Factors of Fever in Portal Hypertensive Patients after Combined Operation

作　　者：申桂娟[1] 王李华[1] 余耀生[1] 徐森花[1] 诸葛勇华[1] 孙平平[1] 姜仁鸦[1] 

机构地区：[1]衢州市人民医院,浙江衢州324000

出　　处：《中华医院感染学杂志》2006年第2期161-163,共3页Chinese Journal of Nosocomiology

基　　金：衢州市科技计划基金(20042027)

摘　　要：目的探讨门静脉高压症患者联合手术(断流术+分流术)后发热的原因及危险因素。方法对45例门静脉高压症行联合手术的患者进行回顾性+前瞻性调查。结果88%术后发热系并发症所致;胸腔积液并或脾窝、膈下积血积液或并感染最常见;持续性发热与肝功能分级显著相关(P<0.01),术前病程长曾有腹水或出血并发症,肝功能失代偿纠正不彻底,术中自由门静脉压力(FPP)≥42cmH2O、出血>800 ml、腹水、手术时间≥5 h等是术后发热的主要危险因素。结论正确掌握手术时机和适应证,术前使患者的肝功能提到A或B级、积极有效的围手术处理、细致的手术操作等是预防术后发热的有效措施。OBJECTIVE To investigate the causes of fever and risk factors in portal hypertensive patients after combined operation （devascularization＋shunt）. METHODS Forty five cases of portal hypertension （PHT） after combined operation were retrospectively and prospectively analyzed. RESULTS Complications caused 88% post operational fever. The most common cause was hydrothorax, hematocele or hydrops and infection in splenic recess. Long-term fever was related to liver function （P〈0.01）. They were the main risk factors： long course, having aseites and bleeding, uncompletely corrected decompensated liver function, free portal pressure （FPP） ≥42cmH2O, bleeding over 800 ml, operative time≥ 5h and so on. CONCLUSIONS Effective measures of preventing post-operational fever should be taken, including the correct timing for operation and indication, liver function recovered to Child A or B, effective round-operational treats, and careful operation.

关 键 词：门静脉高压症 联合手术 发热 危险因素 

分 类 号：R619.3[医药卫生—外科学]