血小板变化在肝移植术后的意义

目的:探讨肝移植术后早期血小板(Pt)的变化规律,影响因素及其意义。方法:回顾分析63例肝移植患者资料,了解Pt变化规律;对影响其变化的多种因素行单变量的相关分析,多变量的多元回归分析。结果:术后Pt变化规律为第4天最低,第24天最高。术前Pt(t=6.318,P<0.000),术后白细胞(t=2.119,P=0.038)和纤维蛋白降解产物(t=2.024,P=0.048),术中全血的输入量(t=-2.349,P=0.022)与Pt变化存在明显关系。术前中度及以上的Pt下降有明显增高的围手术期并发症(10/12)与死亡率(5/12);术后中度及以上的Pt下降也有明显增高的围手术期并发症(27/37)与死亡率(13/37)。结论:掌握Pt变化规律及影响因素有助于指导临床治疗;Pt是预示肝移植患者并发症,死亡率的重要指标;对影响Pt的因素进行干预可以改善预后。

The Clinical Significance of Thrombocytopenia after Liver Transplantation

Objective:To investigate the change rules,affected factor and clinical roles after early postoperative platelets of liver transplantation.Method:The data of platelet in 63 patients of liver transplantations were retrospectively analyzed by correlation for independent samples and multiple regression analysis for several variables Results:The platelet value has a vale on Day 4 after operation and a apex on Day 24 after operation.The preoperative platelet(t=6.318,P<0.000),postoperative white blood cell count(t=2.119,P=0.038),fibrinous degredation products(t=2.024,P=0.048),blood infusion in operation(r=-2.349,P=0.022)were factors examined for any association with thrombocytopenia.The recipients who have a moderate and severe thrombocytopenia before operation have a clearly ascending in complication(11/12) and mortality(5/12)in peri-operational period.The recipients,similarly,who have a moderate and severe thrombocytopenia after operation have a clearly ascending in complication(29/37)and mortality(13/37).Conclusions:Commanding the change rules and affected reason of platelets is beneficial to clinical treatment.The platelet is a predictor in judging the complication and mortality.We Suggest that improve the amounts of platelet will amdiorate the prognosis of livere transplantation recipient.