肝移植围手术期死亡原因分析及防治措施

目的:分析肝移植围手术期死亡的原因并探讨防治方法。方法:回顾性分析26例肝移植围手术期死亡病例的临床资料,观察术前曾行相关治疗、术中出血量及输血量、术中及术后并发症、围手术期手术次数及死亡原因。结果:死亡患者术前肝、肾、凝血功能较差,术前多数曾行相应手术治疗,术中出血量及输血量较多,术后并发症发生率高,死亡原因主要为MODS、感染及出血。结论:肝移植围手术期间应严密关注影响患者预后的每一个危险环节,术前应精密设计,术中要精细操作,术后需精心管理,做到预防为主,积极个体化治疗,提高肝移植的成功率。

Analysis on the causes of perioperative death in liver transplantation and the prevention methods

Objective:To analyze the causes of perioperative death in liver transplantation and investigate the prevention methods.Methods:To retrospect 26perioperative death cases in liver transplantation,observe the rel-evant treatments had been given,the volumes of hemorrhage and blood transfusion during operation,the complica-tions,the operation times and the causes of death.Results:The functions of liver,renal and blood coagulation before operation in these cases were poor and most of cases had accepted other operations before liver transplantation;the a-mounts of hemorrhage and blood transfusion during operation were large and the incidence of complications was high;the main causes of death were MODS(multiple organ dysfunction syndrome),infection and hemorrhage.Con-clusion:In order to improve the achievement ratio of liver transplantation,we should pay close attention to every risk factor,think highly of prevention and individualized treatment in the preoperative period.