肝移植术后精神并发症的早期诊断与治疗  

Early diagnosis and treatment for psychiatric complications after liver transplantation

作　　者：赵中辛[1] 周主青[1] 丁涵之[1] 郑亚新[1] 张辉[1] 所广军[1] 过欣来[1] 黄安华[1] 李侠[1] 蒋小峰[1] 

机构地区：[1]同济大学附属东方医院普通外科,上海200120

出　　处：《肝胆胰外科杂志》2007年第1期9-11,共3页Journal of Hepatopancreatobiliary Surgery

基　　金：上海市浦东新区专项基金(PK2000-04)

摘　　要：目的探讨肝移植术后精神并发症的早期诊断和治疗。方法回顾性分析24例原位肝移植患者的临床资料,分析肝移植术后精神并发症的发生原因和诊断,总结治疗经验。结果15例患者于术后1周内出现不同程度的精神并发症,其中5例症状较为明显。临床表现为亢奋、躁狂、抑郁、焦虑、睡眠障碍、震颤及认知改变等。术前有无肝性脑病、术后感染及使用免疫抑制剂与术后精神并发症的发生有关。结论肝移植术后精神并发症的发生率较高。病因与多种因素有关,临床表现形式多样。需排除脑桥中央髓鞘溶解症。针对不同病因和及时处理,可有效改善与控制症状。Objective To explore the early diagnosis and treatment for psychiatric complications after liver transplantation. Methods The clinical data of 24 patients with liver transplantation in our hospital were analyzed retrospectively. Results Fifteen patients among 24 patients had psychiatric complications after liver transplantation in one week. The common clinical manifestation was encephalopathy, anxiety, sleep disorder, tremor, and change of cognition. The pre-operation encephalopathy history, post-operation infection and the usage of immunosuppressant were risk factors for psychiatric complications. Conclusion Psychiatric complications are commonly seen after liver transplantation and have a variety of etiology. The diagnosis of psychiatric complications must exclude the representation of central pontine myelinolysis. The effective treatment specific for different etiology can control psychiatric complications.

关 键 词：肝移植 精神并发症 诊断 治疗 

分 类 号：R657.3[医药卫生—外科学]