腹部疾病合并肝硬化患者术后并发症危险因素分析和防治措施.docVIP

腹部疾病合并肝硬化患者术后并发症危险因素分析和防治措施 　　[摘要] 目的 分析腹部疾病合并肝硬化的患者接受手术治疗后并发症的发生情况及影响并发症发生的因素，探讨其防治方法。 方法 选择我院2008年1月～2011年1月入院的腹部疾病合并肝硬化的患者36例，患者均进行手术治疗，统计其术后并发症的发生情况，并将可能影响术后并发症发生的因素进行统计学处理。 结果 腹部疾病合并肝硬化的患者手术后并发症发生率较高。经Logistic回归分析发现，腹水、肝脏Child分级、门脉高压、静脉曲张、术中出血量是患者术后并发症的影响因素。 结论 对于腹部疾病合并肝硬化的患者，手术治疗后应积极进行围术期护理，减少出血量、控制感染、防治腹水等，这是降低患者术后并发症的重要措施。 　　[关键词] 腹部疾病；肝硬化；腹水；门脉高压 　　[中图分类号] R656；R657.3+1 [文献标识码] B [文章编号] 1673-9701（2012）02-0023-02 　　 　　Risk factors and prevention measures of postoperative complications in abdominal disease patients with liver cirrhosis 　　WANG Jianfeng 　　The Second Department of Surgery, Xiaoshan District No.4 People’s Hospital of Hangzhou City in Zhejiang Province, Hangzhou 311225, China 　　[Abstract] Objective To analyze occurrence and influential factors of postoperative complications in abdominal disease patients with liver cirrhosis and discuss prevention measures. Methods We selected 36 cases with liver cirrhosis in our hospital from January 2008 to January 2011, they all received operation. We statisticsed incidence of postoperative complications and factors that might influence postoperative complications for statistical process. Results Incidence of postoperative complications was high. Through logistic regression analysis, we found that ascites, Child classification, portal hypertension, varicose veins and intraoperative blood loss were influencing factors of postoperative complications. Conclusion For abdominal disease patients with liver cirrhosis, perioperative nursing care, reducing blood loss, infection control, prevention and treatment of ascites are key measures to reduce incidence of postoperative complications. 　　[Key words] Abdominal disease; Liver cirrhosis; Ascites; Portal hypertension 　　 　　在临床上，腹部疾病合并肝硬化的患者需要进行手术治疗的情况比较紧急，因为手术和麻醉的应激刺激会使肝硬化的程度进一步恶化，术后患者极易发生低蛋白血症、电解质紊乱、凝血障碍等并发症，更严重者会导致死亡[1]。但如果不及时手术，患者病情危急恐怕错过最佳的治疗时机[2]，故本研究选择我院2008年1月～2011年1月入院的腹部疾病合并肝硬化的患者36例，患者均进行手术治疗，统计其术后并发症的发生情况，分析其可能引起并发症的影响因素，目的是为临床治疗腹部疾病合并肝硬化需手术的患者提供治疗依