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影响原位肝移植术后早期通气时间的相关危险因素。

Relevant risk factors affecting time of ventilation during early postoperative period after orthotopic liver transplantation.

机构信息

Department of Intensive Care Unit, Peking University Third Hospital, Beijing, P.R. China.

出版信息

J Crit Care. 2010 Jun;25(2):221-4. doi: 10.1016/j.jcrc.2009.06.048. Epub 2009 Sep 24.

Abstract

PURPOSE

The aim of this study is to examine the relevant factors affecting the duration of mechanical ventilation after orthotopic liver transplantation.

MATERIALS AND METHODS

The 96 patients who underwent liver transplantation were divided into 2 groups according to whether or not the duration of mechanical ventilation after operation was longer than 24 hours. Nineteen variables, including clinical and experimental variables, were analyzed by t test for continuous variables and chi(2) test for discrete variables. The variables with significance (P < .05) were then analyzed with stepwise logistic regression.

RESULTS

Nine continuous preoperative clinical and experimental variables, including preoperative Child-Pugh stage, time of operation, volume of intraoperative liquid transfusion, volume of intraoperative blood loss, volume of intraoperative blood transfusion, volume of intraoperative urine, time of intraoperative hypotension, postoperative renal failure, and postoperative pulmonary edema revealed significant differences between the 2 groups. Stepwise logistic regression analysis for 9 variables indicated that volume of intraoperative blood loss, volume of intraoperative urine, and postoperative renal failure are relevant independent risk factors.

CONCLUSION

The relevant risks affecting the time of ventilation in patients after orthotopic liver transplantation are multiple. The volume of intraoperative blood loss, volume of intraoperative urine, and postoperative renal failure are independent risk factors.

摘要

目的

本研究旨在探讨影响原位肝移植术后机械通气时间的相关因素。

材料与方法

将 96 例行肝移植术的患者分为术后机械通气时间长于 24 小时组和短于 24 小时组,对包括临床和实验室变量在内的 19 个变量进行 t 检验和卡方检验。对有统计学意义的变量(P<.05)进行逐步逻辑回归分析。

结果

术前 9 个连续临床和实验室变量,包括术前 Child-Pugh 分级、手术时间、术中液体输入量、术中出血量、术中输血量、术中尿量、术中低血压时间、术后肾衰竭和术后肺水肿,在两组间有显著差异。对 9 个变量的逐步逻辑回归分析表明,术中出血量、术中尿量和术后肾衰竭是相关的独立危险因素。

结论

影响原位肝移植术后患者通气时间的相关风险因素较多,术中出血量、术中尿量和术后肾衰竭是独立危险因素。

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