摘要
目的总结并分析同种异体肝移植术后围手术期二次手术的原因及其处理方法。方法对我院自2000年8月～2004年12月实施的120例肝移植患者中16例围手术期二次手术的病例进行回顾性研究，分析肝移植术后围手术期二次手术的常见原因，总结处理方法。结果120例肝脏移植手术中。16例在围手术期进行了二次手术。二次手术的原因中：6例为术后腹腔内出血；5例为术后腹腔内血肿继发感染；1例为术后上消化道出血；1例为术后门静脉血栓溶栓后腹腔内出血；1例为腹腔内出血并可疑胆漏；2例因为移植手术中腹腔内填塞纱布压迫止血，二次手术取纱布。其中13例与腹腔内出血有关。结论肝移植术后早期再次手术主要原因是腹腔内出血。对腹腔内活动性出血，如果凝血功能恢复较好，应尽早手术止血；如凝血功能较差，则腹腔内创面渗血可能性大，可保守治疗，加强凝血物质的输入，待凝血功能恢复后多可自行止血。早期保守治疗可引起腹腔内血肿，导致术后腹腔严重感染。早期手术清除血肿可以减少感染的发生率，改善患者的预后。
Objective To analyze the reasons of the complications which could lead to re-operation during early stage after liver transplantation, and summarize the management of these complications. Methods A retrospective chart analysis and review of 120 liver transplantation performed in our hospital from August 2000 to December 2004. Among which 16 eases of reoperations were identified. Results 16 patients underwent re-operation because of postoperative complications, including abdominal cavity bleeding in 6 patients, infection caused by abdominal cavity hematoma in 5 patients, upper gastrointestinal tract bleeding in 1 patient, biliary fistula in 1 patient and removing the bandage in 2 patients. 11 patients were cured by re - operation, the others died. Conclusions Bleeding in abdominal cavity and infection of hematoma are the major complications, which should be dealt by re - operation as early as possible.
出处
《医学研究杂志》
2006年第1期37-39,共3页
Journal of Medical Research
