肝移植术后并发症的防治(附39例报告)

目的探讨同种原位肝移植术后并发症发生的常见原因与预防及处理措施。方法回顾性分析39例原位肝移植病人的临床资料。结果术后并发症发生20例次:腹腔内出血8例,肝动脉狭窄1例,胆瘘2例,急性排斥反应1例,肺部感染2例,顽固性胸腔积液2例,术后肾功能不全3例,GVHD1例。结论围手术期纠正凝血功能、预防肾功能不全,控制感染及营养支持能减少术后并发症的发生,手术技术的完善是预防肝移植后血管、胆道并发症的关键。

PREVENTION AND TREATMENT OF COMPLICATIONS AFTER LIVER TRANSPLANTATION:REPORTS OF 39 CASES

Objective To investigate the common reasons and prevention and treatment of postoperative complications in orthotopic liver transplantation(OLT).Methods Clinical data of 39 patients undergoing OLT were collected and retrospectively analyzed.Results A total of 20 cases times of complications occurred postoperatively in 39 patients were performed OLT,including secondary abdominal cavity bleeding(n=8),hepatic artery stenosis(n=1),biliary fistula(n=2),acute rejection(n=1).pulmonary infection(n=2),refractoriness pleural fluid(n=2),renal inadequacy(n=3),GVHD(n=1).Conclusion It is important to pay attention to perioperative improvement of coagulative capacity,control of infections and support of nutrition,preservation of renal inadequacy in these patients.Good surgical technique is the key point for preventing vascular and biliary tract complications.