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目的总结肝移植术后颅内出血临床特点,探讨其原因、预防和治疗措施。方法对我院从2003年10月到2005年5月的肝移植病例进行回顾性分析。结果为395例病人做了406次肝移植。7例颅内出血,发病率1.8%(7/395),发生时间2周内5例,1例治愈;29天和40天各1例,均治愈,死亡率57.1%(4/7)。6例病人存在凝血功能障碍,3例高血压,3例术中出血大于15000mL。结论颅内出血是肝移植术后近期的常见死亡原因之一。颅内出血原因是多因素的,应采用减少术中出血、纠正凝血功能障碍、控制血压、抗菌素治疗和开颅手术等综合防治措施。
Objective To summarize the clinical characteristics of intracranial hemorrhage after liver transplantation and to explore its causes, prevention and treatment measures. Methods Retrospective analysis of liver transplantation from October 2003 to May 2005 in our hospital. Results 396 patients underwent 406 liver transplants. Seven patients had intracranial hemorrhage, with a morbidity of 1.8% (7/395). Five patients were cured within 2 weeks and 1 patient was cured. One patient was cured on day 29 and 40, and the mortality rate was 57.1% (4/7). Six patients had coagulopathy, three had hypertension, and three had intraoperative bleeding greater than 15,000 mL. Conclusion Intracranial hemorrhage is one of the most common causes of death after liver transplantation. The cause of intracranial hemorrhage is multifactorial. Comprehensive prevention and control measures such as reducing intraoperative bleeding, correcting coagulation disorders, controlling blood pressure, antibiotic therapy and craniotomy should be used.