| 张霖,张环,周敏,等.肝移植术后临床显著胸腔积液的危险因素分析[J].中国临床保健杂志,2026,29(3):382-386. |
| 肝移植术后临床显著胸腔积液的危险因素分析 |
| Risk factors for clinically significant pleural effusion after liver transplantation |
| 投稿时间：2026-04-05 |
| DOI：10.3969/J.issn.1672-6790.2026.03.017 |
| 中文关键词: 肝移植 胸腔积液 水电解质平衡 危险因素 |
| 英文关键词: Liver transplantation Pleural effusion Water-electrolyte balance Risk factors Fund programs:National Natural Science Foundation of China |
| 基金项目:国家自然科学基金项目 |
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| 中文摘要: |
| 目的 探讨肝移植患者术后出现临床显著胸腔积液(CSPE)的危险因素。方法 回顾性分析2021年1月至2025年12月在中国科学技术大学附属第一医院(安徽省立医院)接受肝移植手术的228例患者的临床资料。根据术后是否行胸腔穿刺或引流将患者分为两组,CSPE组91例,非CSPE组137例。比较两组患者的术前、术中及术后相关临床指标差异,并采用logistic回归分析探寻患者术后出现CSPE的危险因素。结果 与非CSPE组患者比较,CSPE组患者的年龄较大,无肝期时间较长,术后72 h内累计液体平衡量较大,而其估算的肾小球滤过率水平、术中去甲肾上腺素使用率及术后72 h最低血清白蛋白均较低(均P＜0.05)。多因素logistic回归分析显示,年龄及术后72 h累计液体平衡量与CSPE的发生呈正相关(均P＜0.05),而术中去甲肾上腺素使用及术后72 h最低白蛋白水平与CSPE的发生呈负相关(均P＜0.05),术后72 h累计液体平衡量与术后72 h最低血清白蛋白浓度呈负相关(P＜0.05)。结论 肝移植术后患者出现CSPE的危险因素有年龄偏大、围手术期液体平衡量及血清白蛋白低等。 |
| 英文摘要: |
| Objective To investigate the risk factors for postoperative clinically significant pleural effusion in patients undergoing liver transplantation.Methods A retrospective analysis was conducted on 228 patients who underwent liver transplantation at the First Affiliated Hospital of the University of Science and Technology of China from January 2021 to December 2025.Patients were divided into two groups according to whether thoracentesis or pleural drainage was required after surgery:the clinically significant pleural effusion group (n=91) and the non-clinically significant pleural effusion group (n=137).Preoperative,intraoperative,and postoperative clinical variables were compared between the two groups.Logistic regression analysis was performed to identify risk factors associated with clinically significant pleural effusion.Results Compared with the non-clinically significant pleural effusion group,patients in the clinically significant pleural effusion group were older,had a longer anhepatic phase time,and a greater cumulative positive fluid balance within 72 hours after surgery,whereas their eGFR levels,intraoperative norepinephrine use rates,and lowest serum albumin levels within 72 hours postoperatively were lower (all P<0.05).Multivariate logistic regression analysis showed that age and 72-hour cumulative positive fluid balance were positively associated with the occurrence of clinically significant pleural effusion (all P<0.05),while intraoperative norepinephrine use and the lowest serum albumin level within 72 hours were negatively associated with its occurrence (all P<0.05).In addition,the 72-hour cumulative positive fluid balance was negatively correlated with the lowest serum albumin level within 72 hours postoperatively (P<0.05).Conclusions Advanced age,perioperative positive fluid balance,and hypoalbuminemia are significant risk factors for clinically significant pleural effusion after liver transplantation. |
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