肝移植后早期胃肠功能对预后的影响

Gastrointestinal function recovery influences the prognosis of patients after liver transplantation

背景:肝移植患者常合并胃肠功能恢复延迟,可能一定程度影响患者预后。目的:回顾性分析肝移植后胃肠功能完全恢复时间,探讨其与肝移植患者预后的关系。方法:收集2006年1月至2011年10月某省两所三级甲等医院符合纳入标准的254例肝移植后患者的病历资料,对肝移植患者后胃肠功能完全恢复时间进行描述性分析。根据恢复时间不同分为<7d组、7-14d组和>14d组,对比观察各组患者肝移植后并发症发生率、移植后住院天数及住院费用等。结果与结论:254例患者肝移植后胃肠功能完全恢复时间<7d者142例,7-14d者90例,>14d者22例。<7d组患者的感染性并发症(肺部、腹腔、切口)、肝移植后2周血清总胆红素水平、住院时间及住院费用最低,7-14d组次之,>14d组最高,差异均有显著性意义(P<0.05);<7d组肝移植后2周血清白蛋白水平最高,7-14d组次之,而>14d组最低,差异有显著性意义(P<0.05)。而肝移植后肾功能不全、急性排斥反应等并发症发生率差异无显著性意义(P>0.05)。结果表明,肝移植后胃肠功能恢复延迟发生概率较高,其延迟患者肝移植后感染相关并发症发生机会升高、住院时间延长、住院费用增加。

BACKGROUND： Delayed gastrointestinal function recovery often appears in patients after liver transplantation. It may influence patient’s prognosis. OBJECTIVE： To retrospectively analyze the recovery time of gastrointestinal function in patients after liver transplantation, and to explore the influence of the gastrointestinal function recovery after liver transplantation on the prognosis. METHODS： The data of 254 liver transplantation patients selected from two hospitals of Fujian province from January 2006 to October 2011 were collected. The recovery time of gastrointestinal function in liver transplantation patients was descriptively analyzed. This study was divided into three groups （ 7 days group, 7-14 days group and 14 days group） according to the recovery time in order to comparatively observe the incidence of postoperative complications, hospital stay and costs in hospital. RESULTS AND CONCLUSION： Among the 254 cases, 142 cases had the full recovery of gastrointestinal function for 7 days, 90 cases 7-14 days, and 22 cases for 14 days. The patients in the 7 days group had the lowest incidence of complications （lung, abdominal cavity and incision）, 2 weeks postoperative serum albumin level, hospital stay and cost when compared with other two groups, followed by the 7-14 days group, and highest in the 14 days group （P 0.05）; the 2 weeks postoperative serum albumin level was highest in the 7 days group, followed by 7-14 days group, and lowest in the 14 days group （P 0.05）; there were no significant differences in the renal dysfunction after liver transplantation and the incidence of acute rejection （P 0.05）. Higher incidence for patients after liver transplantation with delayed gastrointestinal function recovery may result in higher incidence of postoperative infection complications, longer hospital stay and higher hospital costs.