韦芷欣, 陈颖洁, 李斯婕, 杨志勇. 儿童肝移植术后早期并发症发生风险及预后危险因素分析[J]. 广西医科大学学报, 2024, 41(8): 1157-1163. DOI: 10.16190/j.cnki.45-1211/r.2024.08.008
引用本文: 韦芷欣, 陈颖洁, 李斯婕, 杨志勇. 儿童肝移植术后早期并发症发生风险及预后危险因素分析[J]. 广西医科大学学报, 2024, 41(8): 1157-1163. DOI: 10.16190/j.cnki.45-1211/r.2024.08.008
WEI Zhixin, CHEN Yingjie, LI Sijie, YANG Zhiyong. Analysis of the risk factors for early complications and prognosis after pediatric liver transplantation[J]. Journal of Guangxi Medical University, 2024, 41(8): 1157-1163. DOI: 10.16190/j.cnki.45-1211/r.2024.08.008
Citation: WEI Zhixin, CHEN Yingjie, LI Sijie, YANG Zhiyong. Analysis of the risk factors for early complications and prognosis after pediatric liver transplantation[J]. Journal of Guangxi Medical University, 2024, 41(8): 1157-1163. DOI: 10.16190/j.cnki.45-1211/r.2024.08.008

儿童肝移植术后早期并发症发生风险及预后危险因素分析

Analysis of the risk factors for early complications and prognosis after pediatric liver transplantation

  • 摘要: 目的: 分析儿童肝移植术后早期(术后30 d内)并发症的发生情况及预后危险因素。方法: 回顾性收集2017年8月至2022年8月在广西医科大学第一附属医院行肝移植手术患儿的临床资料,根据患儿有无并发症分为有并发症组和无并发症组,采用单因素及多因素logistic回归分析其术后早期并发症的发生情况及影响因素;根据患儿住院临床结局分为死亡组和存活组,采用单因素及多因素Cox回归分析临床结局相关的危险因素。结果: 纳入160例肝移植术后患儿,有早期并发症的患儿106例(66.3%),其中最常见的并发症为感染52例(32.5%),影响肝移植患儿术后并发症的多因素logistic回归分析显示,有并发症组Child-Pugh分级高,术后d1嗜酸性粒细胞降低是影响肝移植术后患儿发生早期并发症的独立危险因素(均P<0.05)。影响肝移植患儿术后死亡风险的Cox回归多因素分析提示,与存活组相比,死亡组手术时间长、嗜酸性粒细胞降低、有早期并发症是影响肝移植术后患儿死亡的独立危险因素(均P<0.05)。结论: 儿童肝移植术后早期并发症发生率较高,最常见的并发症为感染,因此应重视肝移植术后感染的防治;儿童肝移植术后应动态监测嗜酸性粒细胞计数。

     

    Abstract: Objective: To analyze the early complications (within 30 days after operation) and prognostic risk factors after pediatric liver transplantation. Methods: The clinical data of children who underwent liver transplantation in the First Affiliated Hospital of Guangxi Medical University from August 2017 to August 2022 were retrospectively collected. According to the presence or absence of complications, the children were divided into complication group and non-complication group. Univariate and multivariate logistic regression analysis was used to analyze the occurrence and influencing factors of early postoperative complications. The patients were divided into death group and survival group according to the clinical outcomes of hospitalization. Univariate and multivariate Cox regression analysis were used to analyze the risk factors related to clinical outcomes. Results: Among the 160 children after liver transplantation, 106 (66.3%) had early complications, of which the most common complication was infection (52 cases, 32.5%). Multivariate logistic regression analysis showed that the Child-Pugh grade was high in the complication group, and the decrease of eosinophils on d1 after operation was an independent risk factor for early complications in children after liver transplantation (all P<0.05). Multivariate Cox regression analysis of the risk of death in children after liver transplantation suggested that compared with the survival group, the long operation time, decreased eosinophils, and early complications in the death group were independent risk factors for death in children after liver transplantation (all P<0.05). Conclusion: The incidence of early complications after liver transplantation in children is high, and the most common complication is infection. Therefore, attention should be paid to the prevention and treatment of infection after liver transplantation. Eosinophil count should be monitored dynamically after pediatric liver transplantation.

     

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