中青年肝移植患者术后并发症的风险因素分析

Risk factors analysis of postoperative complications in young and middle-aged patients undergoing liver transplant

目的分析80例行肝移植手术的中青年患者术后并发症的发生情况和危险因素。方法选取2018年1月-2020年5月于华中科技大学同济医学院附属同济医院行肝移植手术的中青年患者80例作为研究对象。收集患者资料,包括一般资料、手术前资料和手术资料等。评估不同肝移植患者术后并发症的危险因素,对单因素分析中有显著影响的因素,进一步采用Logistic多元回归分析独立的风险因素。结果80例患者中,54例有不同程度的感染现象,占67.50%;33例出现精神异常,占41.25%;19例出现肺部感染,占23.75%;2例出现肝性脑病,占2.50%;2例术后死亡,病死率为2.50%。年龄、肝功能等级、手术时间、无肝期时间.精神症状,机械通气和术中出血量均与肝移植术后并发症的发生相关(P值均<0.05)。Logistic多元回归分析结果显示,肝功能等级、无肝期时间、机械通气,术中出血量和手术时间均是术后并发症的独立风险因素(P值均<0.05)。结论肝移植术后并发症发生率高且原因复杂,术前的详细检查和术后的及时监护均可以及早预防术后并发症的发生,做到早诊断、早治疗。

Objective To analyze the incidence of postoperative complications and risk factors in 80 young and middle-aged liver transplant patients.Methods 80 young and middle-aged liver transplant patients who were admitted to Tongji Hospital Tongji Medical College of Hust from January 2018 to May 2020 were selected as the research objects.The data of patients werecollected,including general data,preoperation data and operation data.The risk factors ofpostoperative complications in liver transplant patients were evaluated,and for the risk factorswhich had a significant influence in the univariatc analysis,multiple logistic regression analysiswas further used to analyze the independent risk factors.Results Among the 80 patients,54patients had different degrees of infection,accounting for 67.50%.33 patients had mentaldisorders,accounting for 41.25%.19 patients had pulmonary infection,accounting for 23.75%.There were 2 cases of hepatic encephalopathy,accounting for 2.50%.Two patients diedpostoperatively with a mortality rate of 2.50%.Age,liver function grade,operation time,anhepatic time,psychiatric symptoms,mechanical ventilation and intraoperative blood loss wereall associated with the occurrence of postoperative complications(all P<0.05).Logisticregression analysis showed that liver function grade,anhepatic time,mechanical ventilation,bloodloss and operation time were independent risk factors for postoperative complications(all P<0.05).Conclusion The incidence of complications in liver transplant patients is high and thecauses are complicated.Detailed examinations before surgery and timely monitoring after surgerycan detect the occurrence of complications as soon as possible,achieve early diagnosis and earlytreatment,and prevent and treat complications after liver transplant.