肝移植术后神经精神并发症的原因及临床应对  

Clinical diagnosis and treatment of neuropsychopathic complications after liver transplantation

作　　者：曹海梅[1] 龙烁[1] 

机构地区：[1]中南大学湘雅三医院,湖南长沙410013

出　　处：《中国现代医学杂志》2010年第12期1875-1878,共4页China Journal of Modern Medicine

摘　　要：目的探讨肝移植患者术后神经精神并发症的原因及临床应对方法。方法回顾性分析254例肝移植术后出现神经精神并发症的病因、治疗情况及临床应对方法。结果神经精神并发症发生率54.3%(138/254),其中以谵妄样精神障碍最为多见,但大多数症状不严重,均治愈,仅1例昏迷患者头颅CT检查证实有颅内出血,抢救无效后死亡。有症状组和无症状组在年龄上相比较差异无统计学意义(P>0.05);然而,在性别、手术时间、术前血氨水平、术中输血量及血总胆红素、血肌酐、免疫抑制剂浓度、入住ICU时间和术后感染等方面相比较,两组差异有统计学意义(P<0.05)。结论肝移植术后神经精神异常为常见并发症,医护人员应加强识别、处理和心理辅导,临床上严密观察、健康指导等,可提高患者的生存质量和治愈率。【Objective】To explore etiology and treatment for neuropsychopathic complications after liver transplantation. 【Methods】The clinical data of 254 patients who underwent transplantation in our hospital were retrospectively analyzed for the causes of neuropsychopathy complications and clinical treatment.【Results】138 patients among 254 patients had psychiatric complications after liver transplantation （54.3%）, the common clinical mani festation was encephalopathy, anxiety, There was no significant difference in age （P〉0.05）, but there was significant difference in gender, operation time, preoperative blood ammonia, blood transfusion, total bilirubin, serum creatinine, ICU time, immunodepressant density and postoperative infection （P〈0.05）. 【Conclusion】The incidence of neuropsychopathic complication after liver transplantation is high, the cause and clinical manifestation are multiplicity. We should actively prevent and treat in time to elevate the effectiveness of liver transplantation.

关 键 词：肝移植 神经精神并发症 临床应对 

分 类 号：R657.3[医药卫生—外科学]