肝移植术后肺部感染的临床分析

目的分析肝移植术后肺部感染的高危因素,探讨其防治措施。方法回顾性分析46例成人肝移植病例资料,分为肺部感染组和未发生肺部感染组,分析患者感染的多种危险因素。结果肝移植术后肺部感染的发生率为43.5%,病死率60.0%,感染与术中输液量、术后机械通气时间、血肌酐、白蛋白、腹腔出血、胸腔积液等因素有关,肺部感染组与未发生肺部感染组中的差异有统计学意义(P<0.05)。结论肝移植术后肺部感染病死率较高,肝移植术中尽量控制液体输入量、术后尽快拔除气管插管、预防肾功能不全、加强营养、及时处理大量胸腔积液和腹腔出血是预防肺部感染的重要因素。

Pulmonary Infection after Liver Transplantation:A Clinical Analysis

OBJECTIVE To analyze the risk factors of pulmonary infection after liver transplantation and improve treatment strategy.METHODS Forty six adult patients who underwent liver transplantation were divided into two groups: pulmonary infection group and non-pulmonary infection group.An analysis was performed for the commonly used variables.RESULTS The frequency of pulmonary infection after liver transplantation was 43.5%,the mortality rate in the patients who developed pulmonary infection was 60%.Intraoperative total fluid perfusion, mechanical ventilatory time,serum creatinine,albumin,abdominal bleeding,and hydrothorax after liver transplantation were risk factors of pulmonary infection(P<0.05).CONCLUSIONS The mortality of pulmonary infection after liver transplantation is high.Controlling intraoperative fluid perfusion,extubating as soon as possible,preventing renal dysfunction,improving nutrition,and dealing with hydrothorax and abdominal bleeding in time are important factors to prevent pulmonary infection after liver transplantation.