肝移植术后不常规放置腹腔引流管安全性及可行性探讨

目的:探讨肝移植术后不放置腹腔引流管的安全性及可行性?方法:回顾2010年1月~2013年8月在南京医科大学第一附属医院肝移植中心行肝移植术的患者资料,根据术中是否放置腹腔引流管分成引流组(n = 63)和非引流组(n = 112)?分析比较患者术前因素?术中因素以及围手术期并发症和住院时间?结果:患者在术前因素及术中腔静脉阻断时间?门静脉阻断时间及术中出血?输血情况均未见显著差异?两组患者术后并发症分级(P = 0.78)以及腹腔引流管相关并发症(出血?胆漏?大量腹水?切口渗液等)均未见明显差异?而两组在ICU住院天数及术后住院天数有显著差异(P < 0.01)?结论:肝移植术后不放置腹腔引流管是安全的?

Is it safe and feasible that the liver transplantation without routine prophylactic drainage?

Objective:To analyze the safety and feasibility in orthotopic liver transplantion without abdominal drainage. Methods:we retrospected drains in 175 patients who did liver transplantation in liver transplantation center from January 2010 to September 2013. Patients were divided into a drainage group (n = 63) and a non-drainage group (n = 112) separately according to the application of abdominal drainage. Preoperative factors,factors during operation,perioperative complications and lengths of stay were analyzed and compared. Results:Preoperative factors of patients showed no significant difference.(P > 0.05) No significant difference was noted in the blocking time of vena cava and portal vein,with bleeding and transfusion condition indicating no significant difference either. Furthermore,no significant deviation was noted regarding to complication grading (P = 0.78) and complications related to abdominal drainage (e.g. bleeding,bile leakage,massive ascites,incision drainage). However,significant deviation was noted in the two groups about lengths of stay in ICU and lengths of stay after operation (P < 0.01). Conclusion:It is feasible and safe for not using abdominal drainage after liver transplantation?