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Abstract
目的 观察经典非转流原位肝移植(orthotopic liver transplantation,OLT)术后早期肾功能障碍(renal dysfunction,RD)发生的原因并提供临床参考.方法前瞻性研究了连续48例经典非转流OLT病例,根据术后早期(术后第1周)血清肌酐水平进行分组.对单因素分析后有显著性差异的资料进行多因素回归分析.结果经典非转流OLT术后早期RD的发生率为35.4%.Binary Logistic多元回归分析显示:术前RD、Child-Pugh评分、无肝期门静脉开放后1 h尿量是该术后早期RD的危险因素.结论对于术前明显肾功能障碍或Child-Pugh评分较高的病人,应避免使用经典非转流术式.对于接受经典非转流手术的病人,术前应纠正肾功能异常;术中应避免血流动力学的剧烈波动,保持稳定有效的肾血流灌注,以减少术后早期RD的发生。
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