肝移植术后神经精神并发症的临床分析

目的探讨肝移植术后神经系统并发症的种类、发病率及其相关因素.方法回顾性分析133例原位肝移植患者的临床资料.结果 133例肝移植受者发生神经系统并发症51例,发生率为38.3%;神经系统并发症种类包括脑病、癫痫、脑出血、脑梗死.出现神经系统并发症的患者中有48例痊愈,3例死亡,与神经系统相关病亡率为5.9%.结论神经系统病变是肝移植术后常见并具有潜在危险的并发症,产生的原因是多因素的,免疫抑制剂的神经毒性只是一个促进因素.脑出血的发生多提示预后不良,针对病因的综合治疗和免疫抑制剂的及时调整有利于改善预后.

Clinical Analysis of Neuropsychiatric Complications after Liver Transplantation

Objective To study the classification,incidence and some related factors of neurological complications after liver transplantation.Methods The clinical data of 133 cases of orthotopic liver transplantation were retrospectively studied.Results Neurological complications,including encephalopathy,epilepsy,cerebral hemorrhage and cerebral infarction,occurred in 51 cases,the total incidence was 38.3%.Among the 51 cases with neurological complications,48 cases were cured and 3 cases died,the mortality related to neurological complications was 5.9%（3/51）.Conclusions Neurological complications are common and potentially fatal after liver transplantation involving several factors.The neurotoxicity of immunsuppressive agents is one of the inducible factors of neurological complications.The cerebral hemorrhage often suggests poor prognosis.Combined therapies and timely modulation of the immunsuppressive regimens may improve the patient＇s outcome.