肝移植术后腹腔间室综合征8例分析

Diagnosis and treatment of eight patients with abdominal compartment syndrome after liver transplantation

目的总结肝移植(OLT)并发腹腔间室综合征(ACS)的诊断和处理经验。方法对我院2002年9月—2007年12月8例OLT并发ACS的临床资料进行回顾性分析。结果本组8例ACS患者,7例发生在OLT早期(3 d内),1例发生在OLT术后胆瘘感染(7 d)。8例发生ACS病人均行床边左、右下腹部小切口引流术,1例行短时血液滤过,2例行开腹减压术;8例均治愈。结论ACS是OLT的严重并发症。早期、及时的诊断与根据不同情况采取的个体化综合治疗是改善OLT并发ACS预后的关键。

Objective To investigate the diagnosis and treatment of abdominal compartment syndrome（ACS） after liver transplantation.Methods The clinical data were retrospectively studied in eight patients with ACS after liver transplantation.Results Of the 8 patients,7 began to suffer from ACS no more than three days after liver transplantation,and one began to suffer from it seven days after the transplantation due to infection via bile duct fistula.The patients were operated for drainage in the left/right parts of low belly.Additionally,one patient was treated by temporarily CRRT and another two patients were operated by abdominal decompression.All the patients healed up in the end.Conclusion ACS is the most serious syndrome after liver transplantation,so comprehensive treatment on the basis of early diagnosis acts as the key to overcoming it.