摘要
目的:回顾性分析110例成人肝移植病例的临床资料,以期筛选出影响肝移植围手术期死亡率的危险因素。方法:选择2005-01/2007-12在解放军总医院第二附属医院器官移植中心完成肝移植的资料完整、符合统计学要求的受者110例,均为经典式同种异体原位肝移植,尸体供肝。其中移植后存活﹤30d的10例患者列入围手术期死亡组,移植后存活≥30d的100例患者列入生存组。对影响两组患者移植后转归的因素进行比较分析,并对差异显著的影响因素进行Logistic回归分析。结果:单因素分析结果显示,死亡组受者的终末期肝病模型评分、凝血酶原国际标准化比值、移植术中出血量及输血量均高于生存组(P<0.01),凝血酶原活动度低于生存组(P<0.05)。Logistic回归分析表明,移植前终末期肝病模型评分、凝血酶原活动度是肝移植围手术期死亡率的独立危险因素。结论:移植前终末期肝病模型高评分、凝血酶原活动度低是导致肝移植患者围手术期死亡的主要原因,改善移植前受者的危重病情及凝血功能障碍能够降低肝移植围手术期的死亡率。
OBJECTIVE： To retrospective analyze the clinical data of 110 adult liver-transplant patients in order to screen out the risk factors influencing perioperative mortality of liver transplantation.
METHODS： A total of 110 liver transplant patients were selected from Organ Transplantation Center, the Second Affiliated Hospital of Chinese PLA General Hospital between January 2005 and December 2007. All patients had complete data and met to the requirement of statistics. Classical orthotopic liver transplantation was performed in all patients. All patients were divided into two groups： the survival time of patients ≥ 30 days were assigned as survival group （n=-100） and the survival time of patients 〈 30 days were assigned as dead group （n=10） to supply liver specimens, Factors affecting the prognosis of liver transplantation were compared between the two groups by an univariate ana（ysis, and then a logistic regression analysis was performed with variables that achieved a significant difference in the univariate analysis.
RESULTS： Univariate analysis revealed that the model for end-stage liver disease （MELD） score, international normalized ratio, intraoperative bleeding and blood transfusion of the patients in the dead group were significantly higher than those in the survival group （P 〈 0.01）, and the prothrombin activity in the dead group was significantly lower than that in the survival group （P 〈 0.05）.The logistic regression analysis demonstrated that MELD score and prothrombin activity were the independent risk factors influencing perioperative mortality of orthotopic liver transplantation.
CONCLUSION： High MELD score and low prothrombin activity are the main reasons owning to the perioperative mortality. Improvement of condition and coagulation disorders of patients can decrease the perioperative mortality.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第5期927-930,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
