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肝移植术后不常规放置腹腔引流管安全性及可行性探讨

Is it safe and feasible that the liver transplantation without routine prophylactic drainage?

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【作者】 刘金春张传永李国强游伟张峰

【Author】 Liu Jinchun;Zhang Chuanyong;Li Guoqiang;You Wei;Zhang Feng;Department of Liver Surgery,Liver Transplantation Center,the First Affliated Hospital of NJMU;

【机构】 南京医科大学第一附属医院肝脏外科,卫生部活体肝移植研究所

【摘要】 目的:探讨肝移植术后不放置腹腔引流管的安全性及可行性。方法:回顾2010年1月~2013年8月在南京医科大学第一附属医院肝移植中心行肝移植术的患者资料,根据术中是否放置腹腔引流管分成引流组(n=63)和非引流组(n=112)。分析比较患者术前因素、术中因素以及围手术期并发症和住院时间。结果:患者在术前因素及术中腔静脉阻断时间、门静脉阻断时间及术中出血、输血情况均未见显著差异。两组患者术后并发症分级(P=0.78)以及腹腔引流管相关并发症(出血、胆漏、大量腹水、切口渗液等)均未见明显差异。而两组在ICU住院天数及术后住院天数有显著差异(P<0.01)。结论:肝移植术后不放置腹腔引流管是安全的。

【Abstract】 Objective:To analyze the safety and feasibility in orthotopic liver transplantion without abdominal drainage.Methods:we retrospected drains in 175 patients who did liver transplantation in liver transplantation center from January 2010 to September 2013.Patients were divided into a drainage group(n = 63) and a non-drainage group(n = 112) separately according to the application of abdominal drainage.Preoperative factors,factors during operation,perioperative complications and lengths of stay were analyzed and compared.Results:Preoperative factors of patients showed no significant difference.(P > 0.05) No significant difference was noted in the blocking time of vena cava and portal vein,with bleeding and transfusion condition indicating no significant difference either.Furthermore,no significant deviation was noted regarding to complication grading(P = 0.78) and complications related to abdominal drainage(e.g.bleeding,bile leakage,massive ascites,incision drainage).However,significant deviation was noted in the two groups about lengths of stay in ICU and lengths of stay after operation(P < 0.01).Conclusion:It is feasible and safe for not using abdominal drainage after liver transplantation。

【基金】 国家自然科学基金资助(81273262)
  • 【文献出处】 南京医科大学学报(自然科学版) ,Journal of Nanjing Medical University(Natural Sciences) , 编辑部邮箱 ,2014年09期
  • 【分类号】R657.3
  • 【被引频次】3
  • 【下载频次】92
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