终末期肝病模型评分对终末期肝病患者肝移植预后预测价值的观察.docVIP

终末期肝病模型评分对终末期肝病患者 肝移植预后预测价值的观察 孙 杰1 郭振辉1 赖添顺1 唐柚青2 苏磊2 霍枫3 汪邵平3 浦淼水3 文强2 (广州军区总医院：1MICU科，2ICU科，3肝胆外科，广州 510010) 摘 要：目的 探讨终末期肝病模型（MELD）评分对肝移植患者早期预后的预测价值。方法 回顾87例行肝移植治疗的终末期肝病患者，计算治疗前MELD评分，并与早期并发症的发生和生存率进行分析。结果 本组87例肝移植患者中各种严重并发症发生率为20.7%，住院28d和术后3m生存率分别为89.7%和88.5%；非并发症组和生存组MELD评分均值分别为14.6、12.9，有统计学差异（P＜0.05），并发症组和死亡组MELD评分均值分别为21.6、29.4，亦有统计学差异 （P＜0.05）；与MELD ≤15组相比，16～25组和≥25组并发症发生率均显著增加(P＜0.05)；但16～25组生存活率无统计学差异（P＞0.05），而≥25组生存活率明显降低（P0.05）。结论 终末期肝病患者术前MELD评分分值越高，肝移植后早期严重并发症发生率和死亡率越高。高分值MELD（≥25）是预测肝移植患者术后并发症发生与死亡较好的预测指标。关键词：肝移植；终末期肝病模型；并发症；死亡率；预测价值 中图法分类号：R617；R657.3；R619 文献标识码：on Clinical observation of MELD score in Predicting early-stage outcome of liver transplantation patients with end-stage liver disease Sun Jie1, Guo Zhen-hui1, Lai Tian-shun1, Tang You-qing2, Su Lei2, Huo Feng3, Wang Shao-ping3,Pu Miao-shui3 , Wen Qiang2（1 Department of medical intensive care unit, Guangzhou general hospital of Guangzhou military command, Guangzhou, 510010; 2 Department of intensive care unit; 3.Department of Hepatobiliary Surgery.） [Abstrac]：Objective To assess the predictive value of model for end-stage liver disease (MELD) in evaluation of the early-stage outcome of liver transplantation patients. Methods The MELD scores of 87 patients with end-stage liver disease underwent liver transplantation were calculated, and the early-stage complications and mortality were analyzed. Results The severe complication incidence rate was 20.7%. 28-day and 3-month survival rates were 89.7% and 88.5% respectively. The mean MELD scores of non-complication group, survival group, complication group and death group were 14.6, 12.9, 21.6 and 29.4 respectively. There were significant differences between non-complication group and survival group（P＜0.05）, complication group and death group also(P＜0.05）. Compared to MELD≤15 group, the complication incidence rates increased significantly , the survival rate in MELD16～25 group was not significant different, but ≥25 group de