肝移植手术出血特点及其对术后呼吸功能恢复的影响  

Study on bleeding features of patients undergoing liver transplantation and its impact on recovery respiratory function

作　　者：陈涛[1] 洪丽霞[1] 刘建平[1] 万云乐[1] 林浩铭[1] 王捷[1] 区庆嘉[1] 李燕[1] 卢玉贞[1] 彭书凌[2] 李珏[2] 

机构地区：[1]中山大学附属第二医院器官移植中心,广州510120 [2]中山大学附属第二医院麻醉科,广州510120

出　　处：《岭南现代临床外科》2006年第6期404-406,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的研究肝移植手术中出血特点以及失血/输血量对术后呼吸功能恢复的影响。方法回顾性分析我科于2001年月2～2006年月948例几种不同病因肝移植患者手术过程出血特点以及失血、输血量对呼吸功能恢复的影响。结果病肝切除阶段是主要的出血时间段,广泛渗血为主要特点;不同疾病病因手术出血量明显不同。出血量最多为肝癌合并肝硬化、其它依次为肝硬化、急性重症肝炎、无肝硬化肝癌(P<0.05)。术中出血量大于5000ml明显影响患者术后呼吸功能的恢复,并且造成较高的围手术期并发症及死亡率(P<0.05)。结论肝移植术中大出血与术后呼吸功能恢复和术后并发症关系密切,是影响肝移植成败的重发因素之一。因此,尽量减少手术中出血是非常重要的。Objective To investigate the bleeding features of different liver transplant patients and the impact of volume of transfusion and blood loss on patient＇s recovery of respiratory function. Methods From February 2001 to September 2006, 48 eases received liver transplantation in the bleeding feature and volume of blood loss and blood transtusion to impact recovery of respiratory function were analyzed retrospectively. Results Extensive oozing in resection stage was the main feature of bleeding type in liver transplantation. Liver cancer associated with severe cirrhosis resulted in large volume of blood loss which followed by cirrhosis liver alone, severe acute hepatitis and carcinoma of the liver without cirrhosis （P〈0.05）. Blood loss over 5000ml would result in long duration of ventilation support and more respiratory complications during LT. Conclusion Massive bleeding is closely correlated with postoperative recovery of respiratory function and postoperative complications during liver transplantation and it is one of important factors to effect on the success and failure of liver transplantation. Therefore, it＇s very important to reduce intraoperative bleeding as full as possible.

关 键 词：肝移植 失血 止血 呼吸功能 

分 类 号：R61[医药卫生—外科学]