中国实用儿科杂志

中国实用儿科杂志 ›› 2012, Vol. 27 ›› Issue (07): 526-529.

• 专题笔谈 • 上一篇    下一篇

儿童肝衰竭76例临床及预后分析

黄翩翩，朱朝敏   

  1. 重庆医科大学附属儿童医院感染消化科，重庆400014
  • 出版日期:2012-07-06 发布日期:2012-07-18

Analysis of prognosis of pediatric liver failure in 76 cases. 

   HUANG Pian-pian，ZHU Chao-min. Department of Infection and Gastroenterology，Children’s Hospital Affiliated to Chongqing Medical University，Chongqing 400016，China   

  • Online:2012-07-06 Published:2012-07-18

摘要：

：目的    总结76例儿童肝衰竭临床资料，探讨影响儿童肝衰竭预后的相关因素。方法    选择重庆医科大学附属儿童医院2001年6月至2010年11月收治的76例病历资料，用EXCEL及SPSS18.0软件分析，单因素分析用累积比数logistic回归模型分析，多因素分析用logistic回归模型分析。 结果    （1）儿童肝衰竭治疗好转、治愈率低（17.1%）。（2）本组病例病因不明32例（42.1%），病因明确44例（57.9%），胆道畸形、巨细胞病毒、乙型肝炎病毒及EB病毒感染占72.7%。（3）使用非生物型人工肝治疗12例（15.8%），治疗显效2例，有效1例，治疗无效9例。（4）单因素分析提示，年龄、凝血酶原时间活动度（PTA）、白蛋白、肝性脑病、住院时间、并发症的种数对预后的影响有统计学意义（P均＜0.05）；多因素分析提示，肝性脑病、住院时间是影响患儿预后的独立危险因素（P均＜0.05）。结论    儿童肝衰竭病情进展快、病死率高，病因不明确占多数，肝性脑病、住院时间是影响患儿预后的独立危险因素。分析各种因素对儿童肝衰竭预后的影响可为疾病的诊断、治疗提供帮助。

关键词: 儿童, 肝衰竭

Abstract:

Objective    To summarize the clinical data of 76 cases pediatric liver failure and analyze  the prognostic factors. Methods    All of the 76 cases were selected in Children’s Hospital Affiliated to Chongqing Medical University from Jun.2001 to Nov.2010，which were analyzed by using EXCEL and SPSS18.0 sofewares;one-factor analysis was done by ordinal regression model.Multifactors were  analyzed by logistic regression model. Results    （1）The survival rate of liver failure in children was  only 17.1%. （2）Etiology was not clear in 32 children（42.1%）with liver failure；clear in 44（57.9%） ； 72.7% were caused by congenital biliary malformation，CMV，HBV and EBV infection.（3）Twelve children received non-biological artificial liver treatment，3 of which survived while 9 had no effect.（4） Univariate analysis  showed  that the factors significantly correlated with prognosis were  age，prothrombin activity，albumin，hepatic encephalopathy，hospital stay and complications. Multivariate analysis showed that the factors significantly correlated with prognosis were  hepatic encephalopathy and hospital stay. Conclusion    Liver failure in children progresses quickly，whose mortality rate is high and most of which has unknown aetiology. Factors significantly correlated with prognosis are hepatic encephalopathy and hospital stay. It is meaningful for  diagnosis and treatment to analyze these prognostic factors.

Key words: children, liver failure