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肝移植后神经并发症的发生率及长期生存率

Neurological complications prevalence and long-term survival after liver transplantation.

作者信息

Colombari R C, de Ataíde E C, Udo E Y, Falcão A L E, Martins L C, Boin I F S F

机构信息

Unit of Liver Transplantation, State University of Campinas, Sao Paulo, Brazil.

出版信息

Transplant Proc. 2013 Apr;45(3):1126-9. doi: 10.1016/j.transproceed.2013.02.017.

Abstract

INTRODUCTION

Neurological postsurgical complications are a significant cause of morbidity and mortality occur in transplant recipients impacting their survival.

METHODS

We analyzed the medical records of 269 patients who underwent transplantation between 2000 and 2011, after application of the exclusion criteria Neurological complications were examined according to the period in which they appeared: immediate (1-30 day) early (31-180 days), and late (after 180 days). The survival analysis was based on the first complication.

RESULTS

The majority of transplant recipients were males (73.2%) and white (97.1%) with an overall median age of 49 (range, 18-73) years. Regarding the etiology for transplantation, the most common causes were hepatitis C virus (56.5%) and alcohol (33.1%). Complications, appearing in 29.4% (immediate), 31.5% (early), and 39.1% (late) cases, were encephalopathy, confusion, tremors, headache, and stroke. Patients who had the first complication between 1 and 6 months showed greater mortality than those who had one after 6 months.

CONCLUSIONS

Neurological complications led to longer hospital stays with greater early morbidity and mortality. Knowledge of these complications appears to be extremely important for the multidisciplinary transplantation team to decrease its prevalence as well as to diagnose and treat early.

摘要

引言

神经外科术后并发症是移植受者发病和死亡的重要原因,影响其生存。

方法

我们分析了2000年至2011年间接受移植的269例患者的病历,应用排除标准后,根据神经并发症出现的时期进行检查:即刻期(1 - 30天)、早期(31 - 180天)和晚期(180天后)。生存分析基于首次出现的并发症。

结果

大多数移植受者为男性(73.2%)和白人(97.1%),总体中位年龄为49岁(范围18 - 73岁)。关于移植病因,最常见的原因是丙型肝炎病毒(56.5%)和酒精(33.1%)。并发症出现在29.4%(即刻期)、31.5%(早期)和39.1%(晚期)的病例中,包括脑病、意识模糊、震颤、头痛和中风。在1至6个月出现首次并发症的患者比6个月后出现并发症的患者死亡率更高。

结论

神经并发症导致住院时间延长,早期发病率和死亡率更高。了解这些并发症对于多学科移植团队降低其发生率以及早期诊断和治疗似乎极为重要。

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