公民逝世后器官捐献供肝移植术后早期肝功能不全的危险因素分析

发布时间：2018-04-08 23:21

  本文选题：肝移植　切入点：公民逝世后器官捐献　出处：《青岛大学医学院学报》2017年03期

【摘要】：目的观察公民逝世后器官捐献(DCD)供肝移植术后早期肝功能不全(PGD)的发生情况,并分析PGD发生的危险因素。方法回顾性分析2014年7月—2016年3月于我院器官移植中心行肝移植的42例供受体病人的临床资料,其中供体资料包括性别,年龄,血型,死亡原因,ICU住院时间,脂肪变性的程度,冷缺血时间(CIT),热缺血时间(WIT),术前血丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TB)水平等;受体资料包括性别,年龄,血型,原发病,术前终末期肝病模型(MELD)评分,术中的失血量、输血量、无肝期时间,手术时间,术后ICU住院时间等。对上述因素先进行单因素分析,然后将差异有显著性的因素纳入Logistic回归多因素分析。结果 42例肝移植病人移植术后PGD的发生率为52.4%。PGD组和非PGD组受者术后1、6、12个月的累积生存率分别为95.45%、86.36%、86.36%和95.00%、94.44%、94.44%,组间比较差异无统计学意义(P0.05)。供体ICU住院时间≥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发生的独立危险因素。结论供体ICU住院时间≥72h和CIT≥8h是DCD供肝移植病人术后PGD发生的独立危险因素。缩短供体的CIT和ICU住院时间可能有助于降低肝移植术后PGD的发生率。
[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，

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