肝脏移植术后急性肺损伤的临床观察与处理  

CLINICAL ANALYSIS AND TREATMENT OF ACUTE LUNG INJURY AFTER LIVER TRANSPLANTATION

作　　者：武若君[1] 石炳毅[1] 刘京涛[1] 李秦[1] 杜国盛[1] 蔡忠军[1] 

机构地区：[1]解放军第309医院

出　　处：《解放军医学杂志》2003年第11期1040-1042,共3页Medical Journal of Chinese People's Liberation Army

基　　金：全军医学科研"十五"计划重大项目基金资助课题 (编号 0 1Z0 97)

摘　　要：目的　分析肝移植术后急性肺损伤(ALI)发生原因及处理。方法　监测各项相关指标 ,测定血气分析及其他相关检查、检验。予氧疗 ,抗感染 ,抗排斥反应 ,保肝 ,营养代谢支持 ,利尿与扩血管等综合治疗。结果　肝移植受者 2 1例术后 4 8h内死亡 3例 ,其余18例中发生ALI 14例 ,占 77 8% ,经治疗后各脏器均恢复正常。发生ALI者术前原发病多为肝炎肝硬化肝功能失代偿。结论　肝移植术后ALI发生与原发病、手术损伤、术中血流动力学不稳定、术后出量有一定关系。临床除氧疗外 。Objective To analyze causative factors and treatment of acute lung injury (ALI) after liver transplantation. Methods the correlative parameters, including electrocardiogram, blood oxygen saturation, blood pressure, hemodynamics, blood sugar, analysis of arterial blood gases, and other clinical examinations were monitored dynamically. The recipients were treated with oxygen inhalation, antibiotics, immunosuppressant, drugs for liver protection, nutritional support, diuretics, and vasodilators. Results Three of a total of 21 patients died within 48h post operation. Fourteen patients suffered from ALI (14/18, 77 8%), who recoverd after receiving appropriate treatment. Conclusion The occurrence of ALI is related to the primary disease, operative trauma, instability of the hemodynamics, and the quantity of blood loss. Systemic treatment is necessary for the patients with ALI besides the oxygen therapy.

关 键 词：肝移植 成人型呼吸窘迫综合征 重症监护 

分 类 号：R657.3[医药卫生—外科学]