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肝移植术后早期腹腔出血及其处理的探讨 |
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【摘要】 目的 观察肝移植术后早期腹腔出血的相关因素,分析不同处理对预后的影响。方法 对我院行肝移植手术后早期发生腹腔出血患者的围手术期各种相关因素进行观察,并观察保守治疗及手术止血治疗对预后影响。结果 肝移植患者术前存在不同程度的凝血功能障碍,术后凝血功能较术前差。发生腹腔出血患者原发病大多为肝炎后肝硬化,术前MELD评分较正常组高(P<0.01)。保守处理组凝血功能较手术组要差且并发症多死亡率高。而在手术后止血使用重组活化凝血因子Ⅶa有引起肝动脉栓塞的风险。结论 肝移植术后腹腔出血患者,应立刻给予保守治疗,如出血仍无法控制时,应尽快进行手术治疗。重组活化凝血因子Ⅶa有肝动脉栓塞的危险,不宜使用。
【关键词】 肝移植; 腹腔出血; 保守治疗; 重组活化凝血因子Ⅶa
Early-stage Intra-Abdominal Hemorrhage in Patients Underwent Liver Transplantation and its Treatment.
LAI Tian-shun, GUO Zhen-hui, SUN Jie, TANG You-qing, HUO Feng, SU Lei
(Guangzhou General Hospital of Guangzhou Military Command, Guangzhou,510010,China)
Abstract: Objective To observe related factors of early-stage intra-abdominal hemorrhage in patients underwent liver transplantation and to analyze prognosis of different treatments.Methods Peri-operational related factors of early-stage intra-abdominal hemorrhage patients underwent liver transplantation were observed, and the coagulopathy and prognosis of conservative groups and operation groups were compared.Results Coagulation disorder existed before liver transplantation and deteriorated after operation. Hepatic cirrhosis after hepatitis was the most of the underlying disease of intra-abdominal hemorrhage patients. And the [1] [2] [3] [4] [5] 下一页 上一个医学论文: 血浆组织因子和血管内皮因子在颌面部恶性肿瘤中的变化 下一个医学论文: 继发于系统性红斑狼疮的抗磷脂综合征肾病1例
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