前列地尔在肝移植中使用的临床意义评价  

The evaluation for the effect of Liposomal prostaglandin E_1 in liver transplantation recipients

作　　者：赖威[1] 卢实春[1] 赵纪春[1] 严律南[1] 李波[1] 文天夫[1] 王文涛[1] 马玉奎[1] 刘隽[1] 戴军[1] 赵冀[1] 周静[2] 潘传芳[2] 邓承琪[2] 罗燕[3] 彭玉兰[3] 马步云[3] 

机构地区：[1]四川大学华西医院普外科,华西肝移植中心,610041 [2]四川大学华西医院血液检验室,2610041 [3]四川大学华西医院彩超室,3610041

出　　处：《消化外科》2004年第5期308-312,共5页Journal of Digestive Surgery

摘　　要：目的　了解前列地尔 (前列腺素E1的微脂球载体制剂 ,LipoPGE1)对肝移植受体术后血小板聚集功能、肝血供、肝功能及凝血功能、血栓形成的影响 ,以评价前列地尔使用于临床肝移植的意义。方法　以肝移植术后使用前列地尔 (10 μgivq12h ,连续 7d)的 4 0例为治疗组 ,于术前、术后7、10d分别检测其血小板聚集功能、凝血功能、肝功能 ,同时以彩色多普勒超声检测受体肝动脉、门静脉血流峰值 ,比较术前术后上述各指标的变化 ;同时以 36例未使用前列地尔的肝移植受体为历史病例对照组 ,比较两组术后肝血管血栓形成的差异。结果　前列地尔虽然对肝移植术后血小板聚集功能的抑制统计学意义不显著 ,但在治疗组 ,使用前列地尔 7d后 ,移植肝的动脉血供较术前显著增加 ,并且在停药 3d后仍维持于高于术前的水平 ,对早期肝功能的恢复、凝血功能的改善有明显的促进作用 ;对预防术后肝血管尤其是肝动脉血栓形成有一定帮助。结论　前列地尔在肝移植术后使用对早期肝动脉的血供增加有显著的促进作用 ,有利于移植肝的存活和功能恢复。Objective To evaluate the influences of Liposomal prostaglandin E 1 (Lipo PGE 1) on clinical liver transplantation by finding out on platelet aggregation, hepatic inflow, liver function, viability of implanted liver and blood coagulation function in patients with liver transplantation. MethodsLipo PGE 1 was infused by 10 μg iv q12 h in forty liver transplantation recipients from 1 to 7 post OLT days. The platelet aggregation , blood coagulation function and liver function pre- and post-operation day 7, 10 were investigated respectively. And evaluation of hepatic arterial, portal vein inflow and inferior vena cava were taken by color Doppler flow image simultanously. Results Although Lipo PGE 1 could not restrain platelet aggregation significantly, hepatic artery velocity were increased significantly on post-operation day 7, and the elevation continued to post-operation day 10. The improvement of the liver function and blood coagulation were observed. The efficacy of preventing hepatic artery, portal vein and post-hepatic inferior vena cava from thrombosis were reliable. Conclusions Lipo PGE 1 can increase hepatic artery inflow early after OLT, improve blood coagulation function and liver function, and prevent thrombosis to a certain extent.

关 键 词：肝移植 前列腺素E1 血小板聚集 血栓形成 肝血流 肝功能 

分 类 号：R657.3[医药卫生—外科学]