影响肝移植术后机械通气时间的相关因素

Relative Factors Affecting Time of Mechanical Ventilation after Orthotopic Liver Transplantation

目的:探讨影响肝移植术后机械通气撤离时间的相关因素。方法:根据术后24 h内是否可以撤离机械通气,将96例肝移植术后患者分为两组。以术前、术中及术后常用的临床及实验室18项指标作为相关影响因素的分析对象,进行单因素分析,将单因素分析有统计学意义的指标再进行stepwise logistic回归分析。结果:患者术前CHILD分级、手术时间、术中输液量、术中出血量、术中输血量、术中尿量、术中低血压持续时间、术后肾功能衰竭8项指标两组间的差异有统计学意义(P<0.05);术中失血量、术中尿量和术后肾功能衰竭是三个独立相关影响因素。结论:影响肝移植患者术后机械通气时间的因素是多方面的,术中出血量多、尿量减少、术后出现肾功能不全是相关独立影响因素。

Objective ：To study the relative factors affecting the time of mechanical ventilation after orthotopic liver transplantation（OLT）. Methods： 96 patients who underwent liver transplantation were divided into two groups according to whether or not the time of using mechanical ventilation after opreration was longer than 24 hours. Eighteen variables ,including clinical and experimental variables were analyzed by t test for continuous variables and x^2test for discrete variables. The variables with significance （P〈0.05） were then analyzed with stepwise logistic regression. Results： Eight continuous preoperative clinical and experimental variables ,including preoperative Child-Pugh stage,time of operation, volum of intraoperative liquid transfusion,volume of intraoperative bloodloss,volum of intraoperative blood transfusion,volum of intraoperative urine,time of intraoperative hypotention,postoperative renal failure had significant difference between two groups. The stepwise logistic regression analysis for 8 variables demonstrated that volume of intraoperative bloodloss, volum of intraoperative urine and postoperative renal failure were the independent relative factors. Conclusion ： The relative risks of affecting the time of ventilation in patients after OLT are multiple. The volume of intraoperative bloodloss,volum of intraoperative urine and postoperative renal failure are the independent risk factors.