|本期目录/Table of Contents|

[1]阳文新,何咸兵,王跃华,等.肝移植术后弥漫性脑病的特点及危险因素分析[J].医学研究与战创伤救治(原医学研究生学报),2012,14(05):396-398.
　YANG Wen-xin,HE Xian-bing,WANG Yue-hua,et al.Features of diffuse encephalopathy after liver transplantation and its risk factors[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2012,14(05):396-398.
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肝移植术后弥漫性脑病的特点及危险因素分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第14卷
期数:
2012年05期
页码:
396-398
栏目:
出版日期:
2012-09-20

文章信息/Info

Title:
Features of diffuse encephalopathy after liver transplantation and its risk factors
文章编号:
1672-271X(2012)05-0396-03
作者:
阳文新1; 何咸兵2; 王跃华3; 周 斌2; 于乐成3; 何长伦3; 申 红1; 王 轩3
210002 江苏南京，解放军81医院，1.ICU，2.麻醉科，3.全军肝病中心
Author(s):
YANG Wen-xin1; HE Xian-bing2; WANG Yue-hua3; ZHOU Bin2; Yu Yue-cheng3; HE Chang-lun3; SHEN Hong1; WANG Xuan3
1.ICU,2.Department of Anesthesiology,3.Center of Liver Diseases of PLA，81 Hospital of PLA，Nanjing,Jiangsu 210002，China
关键词:
肝移植; 弥漫性脑病; 危险因素; 预后
Keywords:
liver transplantation;  diffuse encephalopathy;  risk factors;  prognosis
分类号:
R657.3
DOI:
-
文献标志码:
A
摘要:
目的 探讨肝移植术后弥漫性脑病(diffuse encephalopathy，DEP)的临床特征、影响因素、防治措施及预后。方法 回顾性分析187例原位肝移植的临床资料，以术后发生DEP者为Ⅰ组，无DEP者为Ⅱ组，比较两组各项临床参数。结果 肝移植术后DEP发生率13.37%。术前Ⅰ组和Ⅱ组慢加急性肝衰竭占48.0%和18.5%(P<0.01)；肝功能Child C级占88.0%和65.4%(P<0.05)；终末期肝病模型评分为(22.83±10.54)和(13.24±11.36)(P<0.05)；总胆红素为(348.6±244.8)μmol/L和(174.3±134.2) μmol/L(P<0.01)；血氨为(67.9±24.7)μmol/L和(39.7±14.8)μmol/L(P<0.05)。术中Ⅰ组和Ⅱ组出血量分别为(4108±1513)ml和(3112±1260)ml(P<0.05)；平均动脉压<70mmHg例数占92.0%和64.8%(P<0.05)；低血压持续时间为(12.4±6.4)min和(7.5±4.6)min(P<0.05)；术后Ⅰ组和Ⅱ组病死率为16.0%和4.94%(P<0.05)。结论 肝移植术后DEP与原发病种类及严重度、术中出血量及低血压持续时间、术后免疫抑制剂血药浓度等显著相关。
Abstract:
Objective To investigate the clinical features,influencing factors,prevention measures and prognosis of diffuse encephalopathy (DEP)in patients with orthotopic liver transplantation (OLT).Methods 187 patients with OLT were divided into group Ⅰ with DEP and group Ⅱ without DEP ,and their clinical parameters were retrospectively analyzed.Results Patients of group I accounted for 13.37% of the whole.Before OLT,the percentage of patients in group Ⅰ and Ⅱ diagnosed as acute on chronic liver failure were 48.0% and 18.5% respectively (P<0.01).Patients of Child C accounted for 88.0% and 65.4% respectively (P<0.05).Model for end-stage liver disease score was (22.83±10.54) and (13.24±11.36) (P<0.05).Total serum bilirubin was (348.6±244.8) μmol/L and (174.3±234.2) μmol/L (P<0.01).Serum ammonia was (67.9±24.7) μmol/L and (39.7±14.8) μmol/L (P<0.05).During the OLT operation of group I and II,the volume of blood loss was (4108±1513) ml and (3112±1260) ml (P<0.05).Patients with the MAP less than 70 mmHg were 92.0% and 64.8%(P<0.05),and the duration of hypotension persisted for (12.4±6.4)min and (7.5±4.6)min respectively (P<0.05).After the OLT operation of group I and II,the mortality was 16.0% and 4.94% respectively (P<0.05).Conclusion Liver transplantation postoperative DEP associated with primary disease type and severity,amount of intraoperative bleeding and hypotensive duration,the blood concentration of immunosuppressor,significant correlation.

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备注/Memo

备注/Memo:
南京军区“十一五”重点项目资助(09Z011)
更新日期/Last Update: 2012-09-20