CAJ | 학술논문

目的探讨终末期肝病模型(MELD)评分和血清钠浓度及腹水情况对良性终末期肝病患者肝移植术后生存情况的评估作用.方法回顾性分析1999年1月至2007年2月福州总医院临床医学院98例行肝移植的良性终末期肝病患者的临床资料.分析患者术前在相同MELD评分下血清钠浓度、腹水情况与手术预后的关系.采用Kaplan-Meier法绘制生存曲线、X2检验比较分组后患者的1年生存率、Fisher精确概率法比较相同MELD评分下患者术后3个月病死率.结果在MELD评分为15～25分和＞25分的情况下,血清钠浓度≥130 mmol/L的患者术后3个月病死率分别为5%和15%,低于血清钠浓度＜130 mmol/L患者的33%和55%,其1年生存率比较差异有统计学意义(x2=12.88,P＜0.05).MELD评分在15～25分和＞25分的情况下,无腹水的患者术后3个月病死率分别为5%和8%,低于有腹水患者的35%和57%,其1年生存率比较差异有统计学意义(x2=15.26,P＜0.05).结论将血清钠浓度、腹水情况与MELD评分结合,能更准确的评估良性终末期肝病患者肝移植术后短期生存情况.
목적 탐토종말기간병모형(MELD)평분화혈청납농도급복수정황대량성종말기간병환자간이식술후생존정황적평고작용.방법 회고성분석1999년1월지2007년2월복주총의원림상의학원98례행간이식적량성종말기간병환자적림상자료.분석환자술전재상동MELD평분하혈청납농도、복수정황여수술예후적관계.채용Kaplan-Meier법회제생존곡선、X2검험비교분조후환자적1년생존솔、Fisher정학개솔법비교상동MELD평분하환자술후3개월병사솔.결과 재MELD평분위15～25분화＞25분적정황하,혈청납농도≥130 mmol/L적환자술후3개월병사솔분별위5%화15%,저우혈청납농도＜130 mmol/L환자적33%화55%,기1년생존솔비교차이유통계학의의(x2=12.88,P＜0.05).MELD평분재15～25분화＞25분적정황하,무복수적환자술후3개월병사솔분별위5%화8%,저우유복수환자적35%화57%,기1년생존솔비교차이유통계학의의(x2=15.26,P＜0.05).결론 장혈청납농도、복수정황여MELD평분결합,능경준학적평고량성종말기간병환자간이식술후단기생존정황.
Objective To investigate the efficiency of model for end-stage liver disease(MELD)score,serum sodium concentration and aseites condition in the evaluation of short-term survival rate of patients with benign end-stage hepatopathy after liver transplantation.Methods The clinical data of 98 patients with benign end-stage hepatopathy who had undergone liver transplantation in Fuzhou General Hospital from January 1999 to February 2007 were retrospectively analyzed.The relationship between serum sodium concentration.ascites condition and the prognosis of patients with the same MELD score was analyzed.Kaplan-Meier survival curve was drawn.The 1-year survival rate of the patients was analyzed by chi-square test.The mortality of patients with the same MELD score at the end of the third month after operation was analyzed by Fisher's exact test.Results MELD score of aIJ patients was 15-25 or＞25.The postoperatire 3-month mortality rates of patients with serum sodium concentration≥130 mmol/L were 5%and 15%.which were significantly lower than 33%and 55%of those with serum sodium concentration＜1 30 mmol/L.The difference upon 1-year survival rates between them had statistical significance(x2:12.88,P＜0.05).The postoperative 3-month mortality rates of patients without ascites were 5%and 8%.which were lower than 35%and 57%of those with aseites.and the difference upon 1-year survival rates between them had statistical significance(X2=15.26.P＜0.05).Conclusions It is more accurate to evaluate the short-term survival rate after liver transplantation for benign end-stage hepatopathy by combining the MELD score with serum sodium concentration and ascites condition.