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目的研究肝移植术后发生急性肺损伤(Acute lung injury,ALI)的危险因素。方法回顾性分析100例终末期肝病患者肝移植术后的临床资料。进行单因素及多因素回归分析肝移植术后发生ALI的危险因素。结果13例患者(13%,13/100例)被诊断为肝移植术后ALI。logistic回归分析显示术中大量输血(输血量超过5000 ml)和严重的再灌注损伤(血清丙氨酸转氨酶超过600 U/L)是肝移植术后急性肺损伤的独立危险因素。术中大量输血的患者发生ALl的危险增加12.7倍;严重的再灌注损伤发生ALl的危险增加7.0倍。结论大量输血和再灌注损伤是肝移植术后发生ALI的两个重要危险因素。ALI是肝移植术后严重的多因素并发症,有很高的死亡率。
Objective To study the risk factors of acute lung injury (ALI) after liver transplantation. Methods The clinical data of 100 patients with end-stage liver disease after liver transplantation were retrospectively analyzed. Univariate and multivariate regression analysis of risk factors for ALI after liver transplantation. Results Thirteen patients (13%, 13 of 100) were diagnosed as ALI after liver transplantation. Logistic regression analysis showed that intraoperative blood transfusions (blood transfusion more than 5000 ml) and severe reperfusion injury (serum alanine aminotransferase more than 600 U / L) were independent risk factors for acute lung injury after liver transplantation. In patients with a large number of transfusions, the risk of developing ALI increased 12.7-fold; the risk of ALI following severe reperfusion injury increased 7.0-fold. Conclusion A large number of blood transfusion and reperfusion injury are two important risk factors of ALI after liver transplantation. ALI is a serious multifactorial complication after liver transplantation and has a high mortality rate.