【摘要】目的分析肝臟移植患者術(shù)后并發(fā)急性肺損傷(ALI)的危險(xiǎn)因素,并探討其防治措施。
方法采用回顧性調(diào)查的方法,對(duì)4例肝臟移植患者的相關(guān)資料進(jìn)行分析。
結(jié)果門肺高壓癥、呼吸機(jī)長(zhǎng)期使用、嚴(yán)重感染、全身炎性反應(yīng)綜合征、高凝狀態(tài)、液體超載、腎功能障礙等,是肝移植術(shù)后并發(fā)急性肺損傷及急性呼吸窘迫綜合征(ARDS)的危險(xiǎn)因素。
結(jié)論肝移植術(shù)后易發(fā)生ALI,預(yù)防并減少相關(guān)危險(xiǎn)因素的影響,對(duì)減少術(shù)后ALI及ARDS有重要意義。
引用本文: 石斌,李玉民,李汛,周文策,楊清平,曹農(nóng). 肝移植術(shù)后急性肺損傷的觀察與分析△. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005, 12(1): 63-66. doi: 復(fù)制
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- 1. 鄭樹(shù)森主編.肝臟移植 [M]. 第1版. 北京: 人民衛(wèi)生出版社, 2001∶540~542.
- 2. 朱士俊主編.現(xiàn)代醫(yī)院感染學(xué) [M]. 第1版.北京: 人民軍醫(yī)出版社, 1998∶7~82.
- 3. 劉大為主編.危重病學(xué)分冊(cè)(二十一世紀(jì)醫(yī)師叢書(shū)) [M]. 第1版. 北京: 中國(guó)協(xié)和醫(yī)科大學(xué)出版社, 2000∶144~152.
- 4. 黎鰲主編.創(chuàng)傷后臟器功能不全 [M]. 第1版.石家莊: 河北科學(xué)技術(shù)出版社,1999∶35~75.
- 5. 景華主編.實(shí)用外科重癥監(jiān)護(hù)與治療 [M]. 第1版.上海: 第二軍醫(yī)大學(xué)出版社,1999∶251~252.
- 6. Kuo P. Pulmonary hypertension: consideration in the liver transplant candidate [J]. Transplant Int, 1996; 9(2)∶141.
- 7. Roland Schott,Ari Chaouat, Anne Launoy, et al. Improvement of pulmonary hypertension after liver transplantation [J]. Chest, 1999; 115(6)∶1748.
- 8. 段敏. 肝臟移植患者術(shù)后肺部感染的危險(xiǎn)因素分析 [J]. 中華護(hù)理雜志, 2002; 37(8)∶4.
- 9. 王彥,王寶恩,張淑文.多臟器功能失常綜合癥患者肺功能受損的動(dòng)態(tài)分析 [J]. 中國(guó)危重病急救醫(yī)學(xué), 1999; 11 (2) ∶115.
- 10. Meduri GU. Clinical review: a paradigm shift: the bidirectional effect of inflammation on bacterial growth. Clinical implications for patients with acute respiratory distress syndrome [J]. Crit Care, 2002; 6(1)∶24.
- 11. Taura P, GarciaValdecasas JC, Beltran J, et al. Moderate primary pulmonary hypertension in patients undergoing liver transplantation [J]. Anesth Analg, 1996; 83(4)∶675.
- 12. Nakazawa K, Uchida T, Matsuzawa Y,et al. Treatment of pulmonary hypertension and hypoxia due to oleic acid induced lung injury with intratracheal prostaglandin E1 during partial liquid ventilation [J]. Anesthesiology, 1998; 89(3)∶686.
- 13. Abraham E. Coagulation abnormalities in acute lung injury and sepsis [J]. Am J Respir Cell Mol Biol, 2000; 22(4)∶401.
- 14. Vincent JL. New therapeutic implications of anticoagulation mediator replacement in sepsis and acute respiratory distress syndrome [J]. Crit Care Med, 2000; 28(9 Suppl)∶S83.
- 15. Attanasio M,Gori AM, Giusti B,et al. Cytokines gene expression in human stimulated monocytes is inhibited by heparin [J]. Thromb Haemost, 1997; 77(Suppl)∶9.
- 16. Bernard GR, Artigas A, Brigham KL, et al. The American European consensus conference on acute respiratory distress syndrome: definitions, mechanisms, and relevant outcomes, clinical trial coordination [J]. Am J Respir Crit Care Med, 1994; 149(3)∶818.