肝移植术后急性肺损伤的危险因素

Risk factors of postoperative acute lung injury of liver transplantation

目的研究肝移植术后发生急性肺损伤(Acute lung injury,ALI)的危险因素。方法回顾性分析100例终末期肝病患者肝移植术后的临床资料。进行单因素及多因素回归分析肝移植术后发生ALI的危险因素。结果13例患者(13%,13/100例)被诊断为肝移植术后ALI。logistic回归分析显示术中大量输血(输血量超过5000 ml)和严重的再灌注损伤(血清丙氨酸转氨酶超过600 U/L)是肝移植术后急性肺损伤的独立危险因素。术中大量输血的患者发生ALl的危险增加12.7倍;严重的再灌注损伤发生ALl的危险增加7.0倍。结论大量输血和再灌注损伤是肝移植术后发生ALI的两个重要危险因素。ALI是肝移植术后严重的多因素并发症,有很高的死亡率。

Objective To study the risk factor of postoperative acute lung injury （ALI） after liver transplantation. Methods The clinical data of 100 patients with end-stage liver diseases who received liver transplantations were retrospectively reviewed. The risk factors of postoperative ALI after liver transplantation were analyzed by using single variance analysis and multiple variance regression analysis. Results Thirteen patients （13%, 13/100） altogether were diagnosed as ALI after liver transplantation. Binary logistic analysis revealed that massive transfusion during operation （more than 5000 ml） and severity of reperfusion injury （ALT above 600 U/L） were two independent risk factors of postoperative ALI following liver transplantation. Massive transfusion significantly increased the risk of ALI by 12. 7 times, whereas the severe reperfusion significantly increased the risk of ALI by 7. 0 times. Conclusions ALI is a serious multifactoral complication after liver transplantation with high mortality and fatality. Massive transfusion and the severe reperfusion injury are two independent risk factors with high morbidity and mortality.