肝移植术后并发症的预防与处理(附7例报告)

Prevention and treatment of complications after liver transplantation: report of 7 cases

目的探讨肝移植术后并发症的处理方法及预防措施。方法回顾性分析7例原位肝移植的临床资料。结果7例肝移植病人,无1例围手术期死亡。术后发生并发症共19例次。腹腔出血3例,肺部感染5例,腹腔感染3例,胆道感染1例,肠道感染1例,丙型肝炎病毒感染1例,胆漏1例,胆道狭窄3例,急性左心衰竭1例。术后随访4￣13个月,存活6例,其中最长1例存活期已超过1a。后期死亡1例,死因为胆道梗阻。结论积极预防,及时确诊,正确处理是减少肝移植术后并发症的关键。

[Objective] To investigate the preventions and managements of postoperative complications after liver transplantation. [Methods] The clinical data of 7 cases after liver transplantation was reviewed retrospectively. [Results] 7 cases all survived during perioperative period. A total of 19 cases times of complications occurred postoperatively including abdominal cavity bleeding （3 cases）, pulmonary infection （5 cases）, abdominal infection （3 cases）, biliary infection （1 case）, intestinal infection （1 case）, hepatitis C viral infection （1 case）, biliary leak （1 case）, biliary stricture （3 cases）, acute heart failure （1 case）. With follow-up from 4 months to 13 months after operation, 1 case died from biliary obstruction. The other 6 cases are still alive and one of them have survived for over one year. [Conclusions] Active prevention, early diagnosis and proper treatment are the keys to reduce postoperative complications after liver transplantation.