肝移植术前等待患者的死亡原因分析

目的 调查分析住院等待肝移植患者的死亡原因,为加强肝移植术前等待患者的管理提供方向和依据.方法 回顾性分析我院2003年1月-2007年6月住院等待肝移植手术期间死亡的63例患者等待时间、治疗过程和死亡原因.结果 63例患者的平均住院等待时间为(32.53±17.21)d,重症加强治疗病房(ICU)住院时间为(12.75±9.77)d.等待期间上消化道出血、意识障碍、感染的发生率分别为47.62%、39.68%和74.60%.主要死因感染性休克和感染性多器官功能衰竭(MOF)以及曲张静脉破裂出血的病死率分别为39.68%和26.98%.血液净化治疗对肝性脑病治疗有效.结论 当前肝移植术前等待住院患者的主要死亡原因是感染和致命性上消化道出血.

Analysis of the causes of death in patients awaiting liver transplantation

OBJECTIVE: To analyze the causes of death of patients awaiting liver transplantation, in order to improve the management of these patients. METHODS: Data of 63 patients died in our hospital from January 2003 to June 2007 while waiting for liver transplantation were analyzed retrospectively, including waiting time, general condition, treatment and causes of death. RESULTS: The average length of stay awaiting liver transplantation and stay in intensive care unit was (32.53+/-17.21) days and (12.75+/-9.77)days, respectively. While on the waiting list, the incidence of upper gastrointestinal bleeding, encephalopathy and infection was 47.62%, 39.68% and 74.60%, respectively. The predominant causes of death were septic shock or multiple organ failure (MOF) and varicose vein bleeding, accounting for a mortality of 39.68% and 26.98%, respectively. Blood purification, when used timely, offered therapeutic effects for hepatic encephalopathy and hepatic renal syndrome. CONCLUSION: For the candidates in the waiting list of liver transplantation, the major causes of death were infection and lethal upper digestive tract bleeding.