肝移植术后早期黄疸的原因分析

目的 探讨肝移植术后早期黄疸的原因。方法 回顾性分析87例肝移植患者术后早期黄疸发生的原因及临床特征。结果 87例患者中，术后46例（52．87％）发生黄疸，共发生21种并发症，有17种（80．95％）并发症伴发黄疸，导致黄疸发生的常见原因依次为缺血．再灌注损伤（n=25，28．73％）、胆道并发症（n=23，26．44％）、急性排斥反应（n=19，21．84％）、药物性肝损害（n=4，4．60％）、移植肝病毒感染（n=4，4．60％）、腹腔内或全身严重感染等（n=3，3．45％），有2例（2．30％）原因不明；46例中，部分病例同时存在多个原因。不同原因所致的黄疸，在发生时间、胆红素水平的变化等方面均呈现相应的特征。结论 黄疸是肝移植术后早期较常见的临床表现，导致黄疽的原因复杂，甄别其主要原因，对指导治疗至关重要。

Etiology of early postoperative hyperbilirubinemia after liver transplantation

Objective To investigate the etiology of early postoperative hyperbilirubinemia after liver transplantation.Methods The clinical data of 87 cases of liver transplantation and the etiology of early postoperative hyperbilirubinemia after liver transplantation were analyzed.Results The incidence of early postoperative hyperbilirubinemia after liver transplantation was(52.87 %).In 21 postoperative complications,17((80.95 %)) were associated with hyperbilirubinemia.The causes of hyperbilirubinemia were as follows in turn: ischemic-reperfusion injury(n=(25,28.73 %)),complications of(common) bile duct(n=23,(26.44 %));acute rejection(n=19,(21.84 %));others(n=13,(14.94 %)).(Conclusions) The early postoperative hyperbilirubinemia is the most common clinical manifestation in(patients) undergoing liver transplantation and can be taken as a reliable clinical mark for the postoperative complications and liver functions.The etiology of early postoperative hyperbilirubinemia after liver transplantation is very complicated.Early diagnosis and treatment is helpful to improve the survival of patients undergoing liver transplantation.