Does previous abdominal surgery alter the outcome of pediatric patients subjected to orthotopic liver transplantation?
Does previous abdominal surgery alter the outcome of pediatric patients subjected to orthotopic liver transplantation?
复制标题
既往腹部手术是否会改变接受原位肝移植的儿科患者的结局？
DOI：
10.1016/0016-5085(86)90860-7
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发表时间：
1986
期刊：
影响因子：
29.4
通讯作者：
Starzl,TE
中科院分区：
文献类型：
--
作者：
Cuervas-Mons,V;Rimola,A;VanThiel,DH;Gavaler,JS;Schade,RR;Starzl,TE
本文回顾了1981年2月至1984年5月在匹兹堡大学接受原位肝移植手术的89例连续儿科患者的医学、麻醉和手术记录，以评估既往腹部手术对儿童原位肝移植发病率和死亡率的影响。57例患儿（1组）有腹部手术史，32例患儿（2组）没有。1组患者比2组患者更年轻（p < 0.001），凝血酶原次数（p < 0.01）和血小板计数（p < 0.02）。两组在麻醉时间和术中使用新鲜冷冻血浆或血小板方面无明显差异。组1患者术中红细胞输注量高于组2患者（p < 0.01）。第1组患者术后总感染较多（p < 0.05），这仅仅是由于腹部感染较多（p < 0.05），但总住院时间和重症监护病房时间与第2组患者相似。当第一组的患者被分为接受过Kasai手术的患者和未接受过Kasai手术的患者时，除了年龄外，两组之间没有明显的差异。基于这些数据，我们得出结论，既往腹部手术不影响死亡率、住院或重症监护病房住院时间、血浆或血小板需求以及原位肝移植所需的总麻醉时间，但确实增加了接受该手术的儿童红细胞输注和感染的数量，特别是腹部感染。
The medical, anesthesia, and surgical records of 89 consecutive pediatric patients who underwent an orthotopic hepatic transplantation procedure at the University of Pittsburgh from February 1981 to May 1984 were reviewed to evaluate the effect of prior abdominal surgery upon the morbidity and mortality of orthotopic liver transplantation in children. Fifty-seven children (group 1) had had prior abdominal surgery, whereas 32 (group 2) had not. The group 1 subjects were younger (p < 0.001), had better prothrombin times (p < 0.01), and better platelet counts (p < 0.02) than did those in group 2. No difference in the duration of anesthesia or intraoperative use of fresh frozen plasma or platelets was evident between the two groups. However, group 1 patients were given more red blood cells intraoperatively than were the group 2 patients (p < 0.01). The group 1 patients had more total postoperative infections (p < 0.05), which was due solely to a greater number of abdominal infections (p < 0.05), but similar total hospital and intensive care unit stays as did the group 2 patients. When those in group 1 were divided into those having a previous Kasai procedure versus those who did not, no differences between the two groups were apparent except for age. Based upon these data, we conclude that prior abdominal surgery does not affect mortality, the duration of hospital or intensive care unit stay, plasma or platelet requirements, and total anesthesia time required for orthotopic liver transplantation, but does enhance the number of red blood cell transfusions and infections, particularly abdominal infections, in children undergoing this procedure.