發(fā)布時間：2018-04-08 23:21

  本文選題：肝移植　切入點：公民逝世后器官捐獻　出處：《青島大學(xué)醫(yī)學(xué)院學(xué)報》2017年03期

【摘要】：目的觀察公民逝世后器官捐獻(DCD)供肝移植術(shù)后早期肝功能不全(PGD)的發(fā)生情況,并分析PGD發(fā)生的危險因素。方法回顧性分析2014年7月—2016年3月于我院器官移植中心行肝移植的42例供受體病人的臨床資料,其中供體資料包括性別,年齡,血型,死亡原因,ICU住院時間,脂肪變性的程度,冷缺血時間(CIT),熱缺血時間(WIT),術(shù)前血丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、總膽紅素(TB)水平等;受體資料包括性別,年齡,血型,原發(fā)病,術(shù)前終末期肝病模型(MELD)評分,術(shù)中的失血量、輸血量、無肝期時間,手術(shù)時間,術(shù)后ICU住院時間等。對上述因素先進行單因素分析,然后將差異有顯著性的因素納入Logistic回歸多因素分析。結(jié)果 42例肝移植病人移植術(shù)后PGD的發(fā)生率為52.4%。PGD組和非PGD組受者術(shù)后1、6、12個月的累積生存率分別為95.45%、86.36%、86.36%和95.00%、94.44%、94.44%,組間比較差異無統(tǒng)計學(xué)意義(P0.05)。供體ICU住院時間≥72h(OR=4.612,95%CI=1.283~16.579,P0.05)和CIT≥8h(OR=6.097,95%CI=1.030~36.070,P0.05)是PGD發(fā)生的獨立危險因素。結(jié)論供體ICU住院時間≥72h和CIT≥8h是DCD供肝移植病人術(shù)后PGD發(fā)生的獨立危險因素�？s短供體的CIT和ICU住院時間可能有助于降低肝移植術(shù)后PGD的發(fā)生率。
[Abstract]:Objective to observe the occurrence of PGD in the early stage of donor liver transplantation (OLT) and to analyze the risk factors of PGD.Methods the clinical data of 42 patients undergoing liver transplantation in our hospital from July 2014 to March 2016 were retrospectively analyzed. The donor data included sex, age, blood type, death cause and the length of stay in ICU.The degree of steatosis, cold ischemic time, warm ischemic time, serum alanine aminotransferase (alt), aspartate aminotransferase (AST), total bilirubin (TB), etc.MED score, blood loss, blood transfusion, duration of anhepatic phase, operation time, postoperative ICU hospitalization time, etc.The factors mentioned above were analyzed by univariate analysis, and then the factors with significant difference were included in Logistic regression multivariate analysis.Results the incidence of PGD in 42 patients with liver transplantation was 1: 6 in 52.4%.PGD group and in non-#en1# group. The cumulative survival rate at 12 months was 95.4546.36% and 95.00% respectively. There was no significant difference between the two groups (P 0.05).The hospital stay time of donor ICU 鈮，

本文編號：1723815