成人活体肝移植术后早期感染情况及危险因素分析

摘要

目的：探讨成人活体肝移植术后30天内感染发生的独立危险因素。方法回顾性调查2008年4月至2014年1月在天津市第一中心医院器官移植中心行肝移植术患者143例的临床资料，术后30天内感染发生者作为感染组（27例），未发生感染患者作为对照组（116例）。在两组患者中对文献报道的可能危险因素进行Logistic回归分析，确定术后早期感染的独立危险因素。结果成人活体肝移植术后30天内感染的独立危险因素为术中大量失血〔优势比（OR）＝1.000，95%可信区间（95%CI）＝1.000～1.001〕，术后重症监护病房（ICU）留置时间过长（OR＝1.702，95%CI＝1.025～2.828），肠外营养时间过长（OR＝1.319，95%CI＝1.070～1.625）。结论为降低活体肝移植患者术后早期感染的发生率，在手术过程中应减少失血、缩短术后ICU留置时间和术后肠外营养时间。%Objective To determine the independent risk factors for infection in30 days after adult living donor liver transplantation of our organ transplant center.Methods A retrospective survey was held in143 liver transplant recipients in April2008 to January2014 in our hospital. Postoperative infection occured within30 days were considered as infection group(n=27),with uninfected patients as control group(n=116).The possible risk factors reported in literature were analyzed by Logistic regression analysis in two groups to determine the independent risk factors for early infection.Results Massive blood loss in operation(OR=1.000,95%CI=1.000-1.001), ICU stay time after operation(OR=1.702,95%CI=1.025-2.828), prolonged parenteral nutrition(OR=1.319, 95%CI=1.070-1.625)were the independent risk factors for infection in30days after adult living donor liver transplantation of our organ transplant center.Conclusion In order to reduce the incidence of early postoperative infection in patients with living donor liver transplantation,medical personnel should reduce blood loss during the operation, shorten the postoperative ICU stay time and the parenteral nutrition time.