肝移植预后的影响因素和预测方法的临床进展

目的了解影响肝移植预后的因素以及可以预测肝移植预后方法的研究进展,为肝源的分配以及肝移植围术期的治疗提供指导和参考。方法检索PubMed、CNKI、万方等数据库中关于肝移植预后的影响因素以及预测其预后方法研究的相关文献并对此进行综述和分析总结。结果肝移植作为目前治疗终末期肝病的有效方法,影响肝移植预后的因素主要包括内环境的改变、全身炎症反应以及一般全身情况。在终末期肝病模型基础上结合血钠离子、乳酸、肌肉量以及网织红细胞计数和血红蛋白浓度建立的新预测模型提高了对肝移植预后的预测能力。结论结合影响肝移植预后的因素选择更有针对性的预测肝移植预后模型可能能更准确地预测肝移植患者预后,为围术期管理和治疗提供参考,使有限的肝源发挥最大的价值而挽救更多的生命。

Clinical advances in prognostic factors and predictive methods of liver transplantation

Objective To figure out the factors affecting the prognosis of liver transplantation and the research progress on methods for predicting the prognosis of liver transplantation so as to provide guidance and reference for the distribution of liver sources and the perioperative treatment of liver transplantation.Method The literatures related to the factors influencing the prognosis of liver transplantation and the methods in predicting the prognosis were searched in the PubMed,CNKI,Wanfang,and other databases and the results were analyzed and summarized.Results The liver transplantation was an effective method in the treatment of end-stage liver diseases.The main factors affecting the prognosis of liver transplantation included the change of internal environment,systemic inflammatory response,and general systemic conditions.On the basis of Model for End-stage Liver Disease(MELD),the new prediction model built in combination with the blood sodium ion,lactate,muscle mass,or reticulocyte count and hemoglobin concentration had improved the prognostic prediction ability of liver transplantation.Conclusions It is possible to predict the prognosis of patients with liver transplantation more accurately by selecting a more targeted prediction model combined with the factors affecting the prognosis of liver transplantation.It might provide a reference for perioperative management and treatment and make the limited liver source play the most role and save more lives.