肝移植后早期胸腔积液的病因

背景：胸腔积液是终末期肝病及肝移植后患者常见并发症，如果采取措施不当，可能会增加移植后死亡率。目的：探讨肝移植后患者胸腔积液的发病原因。方法：回顾解放军第309医院全军器官移植中心2009-05/2010-05收治的36例行原位肝移植病例资料，分析移植后早期胸腔积液发生率、危险因素，对左右胸腔积液采用t 检验，对有意义的统计学指标进行Logistic回归分析。结果与结论：肝移植后早期胸腔积液的发生率为72%(26/36)，单纯右侧胸腔积液26例(26/36，72%)，双侧胸腔积液13例(13/36，1%)。Logistic回归分析结果显示，是否二次手术、是否肺部感染、移植后机械通气时间、移植后3 d出入量、基础疾病是移植后发生胸腔积液的易感因素。

Analysis on causes for pleural effusion early after liver transplantation

BACKGROUND: Plural effusion is a common complication in patients with end-stage liver disease and after liver transplantation. Inappropriate measures may increase mortality after liver transplantation.OBJECTIVE: To study the causes for pleural effusion after orthotopic liver transplantation.METHODS: The clinical data of 36 cases of orthotopic liver transplantation who received treatment in the Organ Transplantation Center of the 309 Hospital of Chinese PLA between May 2009 and May 2010 were reviewed. Risk factors and incidence of pleural effusion early after transplantation were analyzed. t test was performed. Logistic regression analysis on significant statistical indices was also performed. RESULTS AND CONCLUSION: The rate of pleural effusion after orthotopic liver transplantation was 72.2% (26/36). Twenty-six cases (26/36, 72.2%) had pleural effusion in the right thoracic cavity and 13 cases (13/36, 1%) in bilateral thoracic cavities. Logistic regression analysis suggested that reoperation, postoperative pulmonary infection, the time of mechanical ventilation, the equilibrium after operation and the entity before operation were independent predisposing factors.