摘要
目的探讨再次肝移植预后的相关危险因素。方法回顾性分析2000年1月—2015年12月再次肝移植患者的临床资料。观察再次肝移植患者的生存状态与各项临床指标的关系。采用二元Logistic回归法分析术后生存相关危险因素。结果再移植术后1、3、5年总体累计生存率分别为63%、52.4%和51.6%,手术时间、术前胆红素水平、术中输血量及术后重症监护病房(intensive care unit, ICU)滞留时间等因素与患者再次肝移植术后生存率有显著相关性。按时间分组,将2000—2004年设为早期组,2005—2015年设为成熟期组。早期组再移植术后1、3、5年累计生存率分别为41.7%、28.6%和28.6%,成熟期组术后1、3、5年累计生存率分别为65.5%、56.1%和54.4%。结论再次肝移植预后不良的因素与患者术前胆红素水平、手术复杂程度及手术经验密切相关。
Objective To investigate the risk factors for the prognosis of liver retransplantation.Methods The clinical data of patients undergoing liver retransplantation from January 2000 to December2015 were retrospectively analyzed.The risk factors related to survival were analyzed by binary logistic regression.Results The 1,3 and 5 years overall cumulative survival rates were 63%,52.4% and 51.6%,respectively.There were significant correlations between the survival rates and the factors such as operation years,preoperative bilirubin level,intraoperative blood transfusion volume,and post-operative intensive care unit(ICU) detention maturity group was established from 2005 to 2015.The 1,3 and 5 years cumulative survival rates in the early group were 41.7%,28.6% and 28.6%,respectively,while those in the maturity group were 65.5%,56.1% and 54.4%,respectively.Conclusion The prognostic factors of retransplantation were closely related to preoperative bilirubin level,surgical complexity and surgical experience.
引文
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