肝移植围手术期死亡原因分析及防治措施

Analysis on the causes of perioperative death in liver transplantation and the prevention methods

目的:分析肝移植围手术期死亡的原因并探讨防治方法。方法:回顾性分析26例肝移植围手术期死亡病例的临床资料,观察术前曾行相关治疗、术中出血量及输血量、术中及术后并发症、围手术期手术次数及死亡原因。结果:死亡患者术前肝、肾、凝血功能较差,术前多数曾行相应手术治疗,术中出血量及输血量较多,术后并发症发生率高,死亡原因主要为MODS、感染及出血。结论:肝移植围手术期间应严密关注影响患者预后的每一个危险环节,术前应精密设计,术中要精细操作,术后需精心管理,做到预防为主,积极个体化治疗,提高肝移植的成功率。

Objective：To analyze the causes of perioperative death in liver transplantation and investigate the prevention methods.Methods：To retrospect 26perioperative death cases in liver transplantation,observe the rel-evant treatments had been given,the volumes of hemorrhage and blood transfusion during operation,the complica-tions,the operation times and the causes of death.Results：The functions of liver,renal and blood coagulation before operation in these cases were poor and most of cases had accepted other operations before liver transplantation;the a-mounts of hemorrhage and blood transfusion during operation were large and the incidence of complications was high;the main causes of death were MODS（multiple organ dysfunction syndrome）,infection and hemorrhage.Con-clusion：In order to improve the achievement ratio of liver transplantation,we should pay close attention to every risk factor,think highly of prevention and individualized treatment in the preoperative period.