【摘要】 目的 探讨肝移植术后机械通气时间延长(PMV)患者的临床特征、预后以及影响PMV发生的相关因素。方法 回顾性分析安徽医科大学第一附属医院器官移植中心2016年4月至2021月4月收治的105例成人肝移植患者资料。根据术后机械通气时间是否超过24 h，分为PMV组(39例)和非PMV组(66例)，比较两组患者一般资料、临床特征和预后，单因素分析和Logistic多因素回归模型筛选影响肝移植术后PMV的因素；使用Kaplan-Meier曲线和Log-rank检验进行生存分析。结果 既往上腹部手术史(OR=0.284，95% CI：0.084～0.963，P=0.043)和术前Child-Pugh评分(OR=1.439，95% CI：1.026～2.017，P=0.035)是肝移植术后PMV的独立影响因素。PMV组术后180 d生存率为74.36%，非PMV组为84.85%，两组差异无统计学意义(Log-rank χ2=0.061，P=0.804)。结论 术前有无上腹部手术和Child-Pugh评分是肝移植术后PMV的独立影响因素。PMV继发耐药菌感染发生率高，但不影响肝移植患者的术后6个月生存率。充分处理患者术前合并问题，减少导致PMV的因素，可以尽可能地缩短机械通气时间，使患者获益。更多还原

【Abstract】 Objective To investigate the clinical features,prognosis of patients with prolonged mechanical ventilation (PMV) after liver transplantation and the related factors affecting the occurrence of PMV.Methods The data of 105 adult patients with liver transplantation from April 2016 to April 2021 treated in the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed.They were divided into PMV group (39 cases) and non-PMV group (66 cases) based on whether the postoperative mechanical ventilation time exceeded 24 hours.The general data,clinical characteristics and prognosis of the two groups were compared.Univariate analysis and logistic regression model were used to screen the factors affecting PMV after liver transplantation.Survival analysis was performed using Kaplan-Meier curves.Results Previous history of upper abdominal surgery (OR=0.284,95% CI:0.084-0.963,P=0.043) and preoperative Child-Pugh score (OR=1.439,95% CI:1.026-2.017,P=0.035) were independent risk factors for PMV after liver transplantation.The 180-day survival rate was 74.36% in PMV group and 84.85% in non-PMV group,with no significant difference (Log-rank χ2=0.061,P=0.804).Conclusions Preoperative upper abdominal surgery and preoperative Child-Pugh score are independent influencing factors of PMV after liver transplantation.PMV results in higher resistance bacterial infections rate without affecting the 6-month survival rate of patients after liver transplantation.Fully handling the preoperative complications and reducing the factors leading to PMV can shorten the time of mechanical ventilation as much as possible,which is beneficial to the patients.更多还原