肝移植术后胸腔积液的诊治分析

Pleural effusion after liver transplantation:diagnosis and treatment

目的总结肝移植术后胸腔积液的诊断及治疗经验。方法选取我院2004年8月至2010年8月116例肝移植病例,通过B超及X线检查胸腔积液情况,对影响呼吸功能的患者实施胸腔穿刺并置放深静脉管抽液,总结诊断及治疗经验。结果 B超检查提示有89例术后发生胸腔积液,占76.7%;X线检查提示有67例术后发生胸腔积液,占57.8%。B超及X线检查差异显著(P<0.01)。胸腔积液主要发生于右侧,左右两侧比较差异显著(P<0.01)。各病种之间比较无明显差异(P>0.05)。结论肝移植术后B超检查诊断胸腔积液的准确度明显高于X线;少数影响呼吸功能的胸腔积液患者需及时行穿刺插管抽液;术前病种与术后胸腔积液无明显关联性。

Objection To summarize the experiences on diagnosis and treatment of pleural effusion after liver transplantation.Methods The data of 116 patients,who had performed liver transplantations in Nanfang Hospital during 2004.08 ～ 2010.08,were reviewed.B-type ultrasonography and X ray examinations were performed to observe the pleural effusion.The central venous catheters were inserted for suction of pleural effusion in patients with restraint symptoms of pulmonary function.Results There was pleural effusion in 89（76.7%） patients examined by B ultrasonography,while in 67（57.8%） patients by X ray.There was significant difference between B-type ultrasonography and X ray examination.The incidence was higher in the right thoracic cavity than in the left.There was significant difference between both thoracic cavities.There were no significant differences between disease types.Conclusions B-type ultrasonoghraphy had higher accuracy of diagnosis for pleural effusion by than X ray.The central venous catheters must be inserted for suction of pleural effusion in patients with restraint symptoms of pulmonary function.There were no significant differences between disease types.