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目的:回顾性分析小儿肝移植术后行非移植手术的麻醉经过与预后，为此类患儿的围手术期麻醉管理提供借鉴。方法:病例资料来源于2017年1月至2020年3月在上海儿童医学中心接受肝移植术后行非移植手术的全部患儿，共计25例。根据手术特点将患儿分为两组：移植并发症相关手术组（R组，15例）和非移植并发症相关手术组（N组，10例）。收集患儿术前诊治经过、实验室检查、术中麻醉及手术记录、术后转运等相关资料进行统计分析。结果:25例患儿均接受机械通气全身麻醉。R组患儿平均年龄明显低于N组（n P<0.05），且急诊手术所占比例、术前ASA分级、手术时间、麻醉时间以及循环波动的发生率均明显高于N组患儿（n P<0.05）。R组患儿中，有7例输注血制品（包括2例使用血管活性药物），有6例患儿术后带管转入儿科重症监护室，其中2例患儿24 h内死亡。而N组患儿术后均返回普通病房，无围手术期死亡病例。n 结论:行移植并发症相关手术的患儿通常术前病情更复杂、一般情况差，且手术时间长、术中循环波动明显，患儿术后回儿科重症监护室和术后24 h病死率也明显增加，麻醉医师需要进行更全面的术前评估与准备、更精细的术中个体化麻醉管理；而行非移植并发症相关的手术麻醉患儿通常术前一般情况较好、手术短小，患儿也能较好地耐受手术与麻醉。“,”Objective:To retrospectively analyze the anesthesia process and prognosis of non-transplant surgery for pediatric patients after liver transplantation, so as to provide evidence for perioperative anesthesia management in such patients.Methods:A total of 25 pediatric patients who underwent non-transplant surgery after liver transplantation in Shanghai Children's Medical Center from January 2017 to March 2020 were enrolled and their clinical data were collected. According to the type of surgery, the patients were divided into two groups: a transplant complication-related surgery group (group R,n n=15), and a non-transplant complication-related surgery group (group N, n n=10). Their data concerning diagnosis process before surgery, laboratory examination, perioperative anesthesia and surgical records and post-operative transfer were analyzed.n Results:All the patients received mechanical ventilation under general anesthesia. Patients in group R presented remarkable decreases in average age compared with those in group N (n P<0.05), as well as increases in the proportion of emergency operations, American Society of Anesthesiologists (ASA) grades before surgery, operation and anesthesia time, and the incidence of cyclical fluctuation compared with those in group N (n P<0.05). In group R, seven patients received blood products transfusion (including two cases of vasoactive agent use), six patients who were admitted to pediatric intensive care unit (PICU) after operation, where two children died within 24 h. Patients in group N returned to ward after operation, without perioperative death cases.n Conclusions:Pediatric patients who underwent transplant complication-related surgery usually have complicated diseases, with poor general condition, long operation time, and obvious cyclical fluctuation during surgery. The postoperative PICU and postoperative 24 h mortality rate also significantly increase. Anesthesiologists need to perform more comprehensive evaluation and preparation before surgery, and more individualized anesthesia management during operation. In contrast, children undergoing non-transplant complication-related surgery usually have better preoperative conditions, with short operation time and better tolerance to surgery and anesthesia.