肝移植术后拔管的研究现状  

The extubation after liver transplantation

作　　者：张景晓[1] 韦中余[1] 

机构地区：[1]武警总医院重症医学科,北京100039

出　　处：《武警后勤学院学报（医学版）》2016年第12期1038-1041,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：目前我国肝移植围手术期病死率已降至5%以下,肝移植术已成为治疗终末期肝病的有效手段。但由于肝移植受体全身状况差、手术时间长、创伤大、围手术期处理十分复杂、术后并发症较多,术后生存率仍有待提高,而术后气管插管的早期拔除有利于患者的恢复。众多的研究者实行了肝移植术后早期拔管,但现在仍没有统一的临床指南。本文主要从早期拔管的定义、发展、优点及其风险、麻醉技术对早期拔管的影响四个方面介绍了肝移植术后早期拔管现状,认为早期拔管在大多数肝移植术后患者中是安全可行的。拔管医师对拔管前患者的全面的、个体化的评估是拔管成功的重要保证。Now the perioperative mortality has dropped under 5%, liver transplantation has become an effective approach to cure endstage liver diseases. As for bad body situation of receiptors, long operation time, heavy injury, complex perioperative treatment and many postoperative complications, the postoperative survival rate still needs to be improved. Early extubation after the operation is good for the patients＇ recovery. In the past 20 years, early extubation after the liver transplantation was performed in many transplant centers.However, there are still no uniform clinical guidelines now. This article was mainly about 4 aspects of postoperative early extubation： the definition, the development, the advantages and risks and anesthetic techniques. Early extubation was safe and feasible in most patients after liver transplantation. The comprehensive and individualized evaluation played an important role in successful early extubation.

关 键 词：肝移植 早期拔管 机械通气 麻醉 

分 类 号：R614[医药卫生—麻醉学]