【摘要】：目的分析小兒活體肝移植圍術(shù)期肺部并發(fā)癥的發(fā)生及其特點。方法 2014年7月1日—2015年4月30日行擇期小兒活體肝移植手術(shù)的患兒20例,男8例,女12例,手術(shù)診斷均為膽道閉鎖。復(fù)習(xí)病歷資料,收集其術(shù)前、術(shù)中和術(shù)后相關(guān)臨床資料進(jìn)行總結(jié),包括患兒的基本資料(年齡、性別、身高、體重等)、住院天數(shù)、術(shù)前合并癥和疾病的嚴(yán)重程度、術(shù)前和術(shù)后肺部的異常情況、輔助檢查結(jié)果、手術(shù)和麻醉情況、術(shù)后肺部并發(fā)癥等。結(jié)果 20例患兒,年齡4~11個月,美國麻醉醫(yī)師協(xié)會分級Ⅲ或Ⅳ級。術(shù)前合并肺部感染14例,未合并肺部感染6例。術(shù)前合并肺部感染的患兒中,行Kasai手術(shù)5例;術(shù)前未合并肺部感染的患兒中,行Kasai手術(shù)4例。術(shù)前合并肺部感染患兒的肝性腦病構(gòu)成比、白細(xì)胞計數(shù)顯著高于未合并肺部感染患兒(P=0.042、0.015)。術(shù)前合并肺部感染患兒的手術(shù)時間為(384.6±81.7)min,顯著長于術(shù)前未合并肺部感染患兒的(334.2±22.9)min(P=0.049)。術(shù)前合并肺部感染的患兒術(shù)后7d內(nèi)合并肺部感染13例,術(shù)后7d后至出院前合并肺部感染9例,術(shù)前未合并肺部感染的患兒分別為5例和3例,兩者間差異均無統(tǒng)計學(xué)意義(P值均0.05)。術(shù)后7d內(nèi)出現(xiàn)肺不張1例(為術(shù)前合并肺部感染患兒),未出現(xiàn)胸腔積液、氣胸和呼吸衰竭。術(shù)后7d后至出院前,術(shù)前合并肺部感染患兒出現(xiàn)肺不張2例、胸腔積液2例、氣胸1例、呼吸衰竭1例;術(shù)前未合并肺部感染患兒僅發(fā)生肺不張1例。結(jié)論術(shù)前合并肺部感染的患兒更容易并發(fā)肝性腦病和白細(xì)胞計數(shù)升高,且可能于術(shù)后7d至出院前發(fā)生肺不張、胸腔積液、氣胸和呼吸衰竭等較嚴(yán)重的并發(fā)癥。
[Abstract]:Objective to analyze the occurrence and characteristics of perioperative pulmonary complications in children with live liver transplantation. Methods from July 1, 2014 to April 30, 2015, 20 children (8 males and 12 females) underwent elective liver transplantation in children, all of whom were diagnosed as biliary atresia. Reviewing the medical records, collecting the clinical data before, during and after operation, including the basic data of the children (age, sex, height, weight, etc.), the days of hospitalization, the severity of complications and diseases before operation, Preoperative and postoperative pulmonary abnormalities, auxiliary findings, surgical and anesthetic conditions, postoperative pulmonary complications, etc. Results 20 cases, aged 4 ~ 11 months, were classified as 鈪，

本文編號：2389903