中国肝脏病杂志（电子版）
中國肝髒病雜誌（電子版）
중국간장병잡지（전자판）
CHINESE JOURNAL OF LIVER DISEASES(ELECTRONIC VERSION)
2015年
2期
96-100
,共5页
肝炎,重型,慢性%肝移植%肺损伤,急性%危险因素%机械通气
肝炎,重型,慢性%肝移植%肺損傷,急性%危險因素%機械通氣
간염,중형,만성%간이식%폐손상,급성%위험인소%궤계통기
Chronic severe hepatitis%Liver transplantation%Acute lung injury%Risk factors%Mechanical ventilation
目的：回顾性分析本院181例慢性重型肝炎肝移植患者的临床资料，分析慢性重型肝炎肝移植术后早期急性肺损伤（acute lung injury，ALI）的危险因素。方法按急性肺损伤（ALI）的诊断标准将181例患者分为两组，急性肺损伤组（ALI）和非急性肺损伤组（non-ALI），比较两组MELD（终末期肝病模型）评分、年龄、5天总入量、5天出入量差、氧合指数（PaO2/FiO2）、无肝期时间、术中输血量、术中补液量和机械通气时间，单因素及多因素回归分析慢性重型肝炎肝移植术后发生ALI的危险因素。结果单因素分析发现MELD评分、年龄、5天总入量、5天出入量差、氧合指数（PaO2/FiO2）、无肝期时间、术中输血量、术中补液量和机械通气时间等8项变量与慢性重型肝炎肝移植术后早期急性肺损伤有统计学差异（P =0.03）。回归分析提示年龄、5天总入量、术中输血量、术中补液量和机械通气时间为慢性重型肝炎肝移植术后早期急性肺损伤的危险因素。结论年龄、术中输血量、术中补液量、机械通气时间和5天总入量为慢性重型肝炎肝移植术后早期急性肺损伤危险因素。
目的：迴顧性分析本院181例慢性重型肝炎肝移植患者的臨床資料，分析慢性重型肝炎肝移植術後早期急性肺損傷（acute lung injury，ALI）的危險因素。方法按急性肺損傷（ALI）的診斷標準將181例患者分為兩組，急性肺損傷組（ALI）和非急性肺損傷組（non-ALI），比較兩組MELD（終末期肝病模型）評分、年齡、5天總入量、5天齣入量差、氧閤指數（PaO2/FiO2）、無肝期時間、術中輸血量、術中補液量和機械通氣時間，單因素及多因素迴歸分析慢性重型肝炎肝移植術後髮生ALI的危險因素。結果單因素分析髮現MELD評分、年齡、5天總入量、5天齣入量差、氧閤指數（PaO2/FiO2）、無肝期時間、術中輸血量、術中補液量和機械通氣時間等8項變量與慢性重型肝炎肝移植術後早期急性肺損傷有統計學差異（P =0.03）。迴歸分析提示年齡、5天總入量、術中輸血量、術中補液量和機械通氣時間為慢性重型肝炎肝移植術後早期急性肺損傷的危險因素。結論年齡、術中輸血量、術中補液量、機械通氣時間和5天總入量為慢性重型肝炎肝移植術後早期急性肺損傷危險因素。
목적：회고성분석본원181례만성중형간염간이식환자적림상자료，분석만성중형간염간이식술후조기급성폐손상（acute lung injury，ALI）적위험인소。방법안급성폐손상（ALI）적진단표준장181례환자분위량조，급성폐손상조（ALI）화비급성폐손상조（non-ALI），비교량조MELD（종말기간병모형）평분、년령、5천총입량、5천출입량차、양합지수（PaO2/FiO2）、무간기시간、술중수혈량、술중보액량화궤계통기시간，단인소급다인소회귀분석만성중형간염간이식술후발생ALI적위험인소。결과단인소분석발현MELD평분、년령、5천총입량、5천출입량차、양합지수（PaO2/FiO2）、무간기시간、술중수혈량、술중보액량화궤계통기시간등8항변량여만성중형간염간이식술후조기급성폐손상유통계학차이（P =0.03）。회귀분석제시년령、5천총입량、술중수혈량、술중보액량화궤계통기시간위만성중형간염간이식술후조기급성폐손상적위험인소。결론년령、술중수혈량、술중보액량、궤계통기시간화5천총입량위만성중형간염간이식술후조기급성폐손상위험인소。
Objective The clinical data of181 cases with liver transplantation of chronic severe hepatitis in our department were analyzed, retrospectively. The risk factors of the early acute lung injury after liver transplantation of chronic severe hepatitis were also analyzed. Methods According to the diagnostic criteria for ALI: 181 patients were divided into two groups, the ALI group and non-ALI group. The socre of the model for end-stage liver disease (MELD), age, total of intake and output and its’ difference in early 5 days, the oxygenation index (PaO2/FiO2), the period of anhepatic phase, the volume of intraoperative blood transfusion and intraoperative lfuid, the duration of mechanical ventilation and MV( Mechanical ventilation ) of the two groups were compared. The risk factors of postoperative ALI after liver transplantation of chronic severe hepatitis were analyzed with the single-factor and multi-factor regression analysis.Results Single factor analysis indicated that there was signiifcant difference (P = 0.03) between the eight variables (such as the score of MELD, age, total of intake and output and its’ difference in early 5 days, the oxygenation index, the period of anhepatic phase, the volume of intraoperative blood transfusion and intraoperative fluid, the duration of mechanical ventilation) and the early acute lung injury after liver transplantation of chronic severe hepatitis. Regression analysis showed that the age, the total of intake and output in early 5 days, the volume of intraoperative blood transfusion and intraoperative lfuid, the duration of mechanical ventilation were the risk factors of acute lung injury after liver transplantation of chronic severe hepatitis.Conclusions The age, the volume of intraoperative blood transfusion and intraoperative lfuid, the duration of mechanical ventilation, the total of intake and output in early 5 days were the risk factors of acute lung injury after liver transplantation of chronic severe hepatitis.
