肝功能衰竭患者肝移植后并发肺炎的危险因素分析

目的 探讨和分析肝功能衰竭患者肝移植后并发肺炎的危险因素.方法 回顾性分析2004年9月至2006年12月80例肝功能衰竭肝移植患者的临床资料.将80例患者分为肺炎组和对照组,应用多因素分析寻找肝功能衰竭患者肝移植后并发肺炎的独立危险因素.结果 肺炎组27例,死亡13例,对照组53例,死亡5例.多因素分析显示肝移植后发生肺炎与患者死亡密切相关(OR=14.857,95%的可信区间为3.703～59.612,P=0.0001).与发牛肺炎密切相关的因素有:年龄(OR=1.976,95%的可信区间为1.090～3.582,P=0.0249)、肝肾综合征(OR=5.266,95%的可信区间为0.912～30.414,P=0.0634)以及移植肝功能不良(OR=91.997,95%的可信区间为19.000～445.440,P=0.0001).肺炎的发生与术前Ⅲ级以上肝性脑病无相关性.结论 肝功能衰竭患者肝移植术后发生肺炎是导致其死亡的主要原因之一;年龄、肝肾综合征和移植肝功能不良是肝移植后发生肺炎的独立危险因素.

Risk factors of pulmonary infection in the liver transplantation recipients with hepatic failure

Objective To investigate the risk factors of pulmonary infection in the liver transplantation recipients with hepatic failure.Methods A retrospective study was performed on the clinical data of 80 patients in our department from Sep.2004 to Dec.2006.The patients were divided into pulmonary infection group (27 cases) and control group (50 cases).Risk factors of pneumonia were analyzed by multiple factor analysis in order to find out reasons of pneumonia.Results In the pulmonary infection group,13 died,and in the control group,5 died.Multiple factor analysis revealed the death was related closely with pneumonia after liver transplantation OR:14.857,CI 95%(3.703-59.612),P=0.0001)].The factors which related closely with pneumonia were as follows:age (OR=1.976,CI 95% (1.090-3.582),P=0.0249),liver-kidney syndrome (OR=5.266,CI 95%(0.912-30.414),P=0.0634)and dysfunction of transplanted liver (OR=91.997,CI 95%(19.000-445.440),P＜0.01).Conclusions Pneumonia was the most important reason of deaths in the liver transplantation recipients suffered from hepatic failure.Age,liver-kidney syndrome and dysfunction of transplanted liver were the independent risk factor of pneumonia after liver transplantation.