术后ICU住院时间对活体肝移植受者谵妄的影响  

Effect of postoperative ICU stay on delirium in living donor liver transp lant recipients

作　　者：田国欣 孙萌[1] 赵丽红 任艳伟 TIAN Guoxin;SUN Meng;ZHAO Lihong;REN Yanwei(Department of General Surgery,Beijing Friendship Hospital,Capital Medi cal University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院普外科,北京100050

出　　处：《当代医药论丛》2023年第13期39-42,共4页

摘　　要：目的:探讨术后重症监护室(ICU)住院时间对活体肝移植受者谵妄的影响。方法:回顾性分析在首都医科大学附属北京友谊医院行活体肝移植的98例受者的临床资料。所有患者均选取首要诊断为乙型病毒性肝炎(乙型肝炎)肝硬化患者,根据其术后ICU住院时间的长短分为短期组(≤72 h)和长期组(>72 h),对两组患者术后谵妄的发生情况进行对比分析。结果:两组患者在年龄、性别、体质指数、急诊手术、合并疾病(高血压、糖尿病、冠心病、慢性呼吸系统疾病、慢性肾病)、术前肝功能指标(谷草转氨酶、谷丙转氨酶)、术前白蛋白、术前血红蛋白、术前血氨、术前肌酐、手术时间、术中出血量方面相比,差异均无统计学意义(P>0.05)。短期组49例患者中,1例患者术后发生谵妄,发生率为2.04%;长期组49例患者中,8例患者术后发生谵妄,发生率为16.33%。长期组患者术后谵妄的发生率显著高于短期组,差异有统计学意义(P=0.03)。结论:术后ICU住院时间对活体肝移植受者早期发生谵妄的影响较大,二者呈正相关。临床上应加强对此类患者术后ICU住院期间的管理,并尽量缩短ICU住院时间,以降低患者术后谵妄的发生率,减少对患者精神状态的影响。Objective:To investigate the effect of length of stay in intensive care unit(ICU)on delirium in living donor liver transplantation recipients.Methods:The clinical data of 98 recipients of living donor liver transplantation in Beijing Friendship Hospital affiliated to Capital Medical University were retrospectively analyzed.All patients with liver cirrhosis with the primary diagnosis of viral hepatitis B(hepatitis B)were selected and divided into short-term group(≤72 h)and long-term group(>72 h)according to the length of postoperative ICU stay.The occurrence of postoperative delirium between the two groups was compared and analyzed.Result:A total of 98 patients were finally included in this study,and were divided into short-term group(≤72 h)and long-term group(>72 h)according to the length of postoperative ICU stay,with 49 cases each.The two groups were compared in terms of age,sex,body mass index,emergency surgery,co-existing diseases(hypertension,diabetes,coronary heart disease,chronic respiratory disease,chronic kidney disease),preoperative liver function indexes(aspartate aminotransferase,alanine aminotransferase),preoperative albumin,preoperative hemoglobin,preoperative blood ammonia,preoperative creatinine,operative time,and intraoperative blood loss.There were no significant differences(P>0.05).In the short-term group of 49 patients,1 patient developed delirium after operation,the incidence was 2.04%;In the long-term group of 49 patients,8 patients suffered from postoperative delirium(16.33%).The incidence of postoperative delirium in the long-term group was significantly higher than that in the short-term group,with statistical significance(P=0.03).Conclusion:The length of ICU stay has a significant influence on the early delirium of living donor liver transplantation recipients,and the two are positively correlated.Clinical management of postoperative ICU hospitalization of such patients should be strengthened,and the length of ICU stay should be shortened as far as possible,so as to reduce the incide

关 键 词：重症监护室 住院时间 活体肝移植受者 谵妄 

分 类 号：R619.9[医药卫生—外科学]