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李春桃, 骆健, 张中伟, 等. 成人活体肝移植术后大量腹水的危险因素分析及其对预后的影响[J]. koko体育app 学报(医学版), 2013, 44(4): 632-636.
引用本文: 李春桃, 骆健, 张中伟, 等. 成年活体肝移植后果酸换肤很大浮肿的有风险性情况定量分析简述对继发性的导致[J]. 北京一本大学学报(生物学版), 2013, 44(4): 632-636.
LI Chun-tao, LUO Jian, ZHANG Zhong-wei, et al. Risk Factors for Massive Ascites after Living Donor Liver Transplantation in Adult and Impact of Massive Ascites on Patient Survival[J]. Journal of Sichuan University (Medical Sciences), 2013, 44(4): 632-636.
Citation: LI Chun-tao, LUO Jian, ZHANG Zhong-wei, et al. Risk Factors for Massive Ascites after Living Donor Liver Transplantation in Adult and Impact of Massive Ascites on Patient Survival[J]. Journal of Sichuan University (Medical Sciences), 2013, 44(4): 632-636.

成人活体肝移植术后大量腹水的危险因素分析及其对预后的影响

Risk Factors for Massive Ascites after Living Donor Liver Transplantation in Adult and Impact of Massive Ascites on Patient Survival

  • 摘要: 目的 探讨成人活体肝移植(LDLT)术后发生大量腹水的危险因素及大量腹水对LDLT患者生存率的影响。 方法 回顾性分析2005~2011年koko体育app 华西医院105例首次接受LDLT患者的临床、实验室资料及供体基本资料,采用单因素分析和两分类logistic回归筛选术后产生大量腹水的危险因素;应用Kaplan-Meier生存曲线分析患者预后,观察大量腹水对患者预后的影响。 结果 105例活体肝移植受体,术后7 d腹水总量每人平均为5 362 mL,平均每日766 mL。术后发生大量腹水27例(25.7%)。单因素分析中两组(大量腹水组和对照组)间差异有统计学意义(P<0.05)的指标有受体年龄、肝脏基础疾病、术前终末期肝病模型(MELD)评分、Child-Pugh评分、术前腹水、术前国际标准化比值(INR)、术前总胆红素、术前血清白蛋白、手术时间、术后序贯性器官功能衰竭评分(SOFA)评分、术后总胆红素。两分类logistic回归分析得出术前腹水(OR=3.33,P<0.001)、术后SOFA评分(OR=1.25,P=0.027)为活体肝移植术后发生大量腹水的独立危险因素。Kaplan-Meier分析结果示对照组3月、6月、1年生存率分别是89.6%、81.2%、79.5%,大量腹水组3月、6月、1年生存率分别是80.8%、80.8%、74.1%,生存率组间比较差异无统计学意义。 结论 术前腹水量、术后SOFA评分是活体肝移植术后发生大量腹水的独立危险因素。产生大量腹水的患者术后生存率与对照组比较无明显差异。  
    Abstract: Objective To analyze the risk factors relate to massive ascites after the living donor liver transplantation (LDLT) in adult and the impact of massive ascites on patient survival. Methods Clinical data of 105 adult patients undergone LDLT from 2005 to 2011 in West China Hospital were retrospectively analyzed. The risk factors for massive ascites were firstly determined with univariate analysis, then with two logistic regression analysis if P<0.1 by univariate analysis. Kaplan-Meier survival curve was used to investigate the association between massive ascites and patient survival. Results The average amount of ascites within seven days postoperatively in 105 LDLT cases was 5 362 mL (766 mL per day), and massive ascites developed in 27 patients (25.7%). The variables, including receptor age, liver disease, preoperative MELD score, Child-Pugh score, preoperative ascites, preoperative INR, preoperative total bilirubin, preoperative serum albumin, operative time, postoperative SOFA score, postoperative total bilirubin, showed significant difference between massive ascites group and non-massive ascites group. Another variable that P<0.1 was graft to recipient weight ratio (GRWR) (P=0.069). The two logistic regression showed that preoperative ascites (OR=3.33, P<0.001), postoperative SOFA score(OR=1.25, P=0.027) were independent risk factors for massive ascites after LDLT. The results of Kaplan-Meier analysis showed that the 3-month, 6-month, 1-year survival rates of control group were 89.6%, 81.2%, 79.5% respectively, and those rates of massive ascites group were 80.8%, 80.8%, 74.1% respectively. The survival of the patients who developed massive ascites after LDLT was reduced when compared with control group, but it was not statistically significant. Conclusion Preoperative ascites, postoperative SOFA score were independent risk factors for massive ascites after LDLT. The impact of massive ascites on patients survival need further investigation.  
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