原位肝移植术前危险因素分析  

An analysis of preoperative risk factors in orthotopic liver transplantation

作　　者：蔡常洁[1] 陈规划[2] 管向东[1,2,2] 何晓顺[2] 管向东[1,2,2] 陆敏强[2] 管向东[1,2,2] 杨扬 黄洁夫[2] 

机构地区：[1]中山医科大学附属第一医院外科重症监护室,广州市510080 [2]中山医科大学附属第一医院器官移植中心,广州市510080

出　　处：《中华肝胆外科杂志》2002年第5期262-264,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　分析与肝移植术后早期死亡率有密切关系的术前危险因素。方法　回顾性地收集 5 0例成人肝移植病人的临床和实验室资料 ,对 2 0种待筛选的术前危险因素与术后早期死亡率的关系进行多元回归分析。结果　经单因素和Logistic多元回归分析最终筛选出术前感染情况、急性生理 ,年龄和慢性健康 (APACHE)Ⅲ评分和血浆肌酐 (Cr)水平与术后早期死亡率有独立相关性。经受试者运算特征 (ROC)曲线分析 ,APACHEⅢ的截断点为 6 0分 ,Cr的截断点为 14 0 μmol/L。 结论　术前APACHEⅢ≥ 6 0分、Cr水平≥ 14 0 μmol/L及术前存在感染灶 ,是肝移植受体的术前危险因素 。Objective To determine preoperative risk factors being related to early mortality after liver transplantation. Methods Clinical and laboratory data of 50 patients underwent liver transplantation were retrospectively analyzed. The relationship between the 20 possible preoperative risk factors and early mortality after orthotopic liver transplantation was investigated using logistic regression. Results Amongst the 20 possible risk factors, only cute physiology, age and chronic health evaluation (APACHE Ⅲ) scores, history of infection and preoperative serum creatinine level had a significant independent association with early mortality. The examination of the receiver operating characteristics (ROC) curve showed that the cutpoints of APACHE Ⅲ score and serum creatinine were 60 points and 140 μmol/L. Conclusions The outcome is poor if a patient has an existence of infection, APACHE Ⅲ score ≥60 and/or serum creatinine ≥140 μmol/L.

关 键 词：危险因素 LOGISTIC回归分析 死亡率 原位肝移植术 终末期肝病 

分 类 号：R657.3[医药卫生—外科学]