慢性重型肝炎肝移植术后急性肺损伤的临床研究  

Clinical analysis on acute lung injury after liver transplantation of chronic severe hepatitis

作　　者：王亚军[1] 韦中余[1] 

机构地区：[1]武警总医院,北京100039

出　　处：《中国肝脏病杂志（电子版）》2015年第2期96-100,共5页Chinese Journal of Liver Diseases：Electronic Version

摘　　要：目的回顾性分析本院181例慢性重型肝炎肝移植患者的临床资料,分析慢性重型肝炎肝移植术后早期急性肺损伤(acute lung injury,ALI)的危险因素。方法按急性肺损伤(ALI)的诊断标准将181例患者分为两组,急性肺损伤组(ALI)和非急性肺损伤组(non-ALI),比较两组MELD(终末期肝病模型)评分、年龄、5天总入量、5天出入量差、氧合指数(Pa O2/Fi O2)、无肝期时间、术中输血量、术中补液量和机械通气时间,单因素及多因素回归分析慢性重型肝炎肝移植术后发生ALI的危险因素。结果单因素分析发现MELD评分、年龄、5天总入量、5天出入量差、氧合指数(Pa O2/Fi O2)、无肝期时间、术中输血量、术中补液量和机械通气时间等8项变量与慢性重型肝炎肝移植术后早期急性肺损伤有统计学差异(P=0.03)。回归分析提示年龄、5天总入量、术中输血量、术中补液量和机械通气时间为慢性重型肝炎肝移植术后早期急性肺损伤的危险因素。结论年龄、术中输血量、术中补液量、机械通气时间和5天总入量为慢性重型肝炎肝移植术后早期急性肺损伤危险因素。Objective The clinical data of181 cases with liver transplantation of chronic severe hepatitis in our department were analyzed, retrospectively. The risk factors of the early acute lung injury after liver transplantation of chronic severe hepatitis were also analyzed. Methods According to the diagnostic criteria for ALI： 181 patients were divided into two groups, the ALI group and non-ALI group. The socre of the model for end-stage liver disease （MELD）, age, total of intake and output and its’ difference in early 5 days, the oxygenation index （PaO2/FiO2）, the period of anhepatic phase, the volume of intraoperative blood transfusion and intraoperative lfuid, the duration of mechanical ventilation and MV（ Mechanical ventilation ） of the two groups were compared. The risk factors of postoperative ALI after liver transplantation of chronic severe hepatitis were analyzed with the single-factor and multi-factor regression analysis.Results Single factor analysis indicated that there was signiifcant difference （P = 0.03） between the eight variables （such as the score of MELD, age, total of intake and output and its’ difference in early 5 days, the oxygenation index, the period of anhepatic phase, the volume of intraoperative blood transfusion and intraoperative fluid, the duration of mechanical ventilation） and the early acute lung injury after liver transplantation of chronic severe hepatitis. Regression analysis showed that the age, the total of intake and output in early 5 days, the volume of intraoperative blood transfusion and intraoperative lfuid, the duration of mechanical ventilation were the risk factors of acute lung injury after liver transplantation of chronic severe hepatitis.Conclusions The age, the volume of intraoperative blood transfusion and intraoperative lfuid, the duration of mechanical ventilation, the total of intake and output in early 5 days were the risk factors of acute lung injury after liver transplantation of chronic severe hepatitis.

关 键 词：肝炎 重型 慢性 肝移植 肺损伤 急性 危险因素 机械通气 

分 类 号：R657.3[医药卫生—外科学]