肝移植术后血清总胆红素及胆汁引流量对预后的影响  

Effect ofearly postoperative hyperbilirubinemiaand T tube bile drainage on prognosis after liver transplantation

作　　者：曹权[1] 徐鑫荣[1] 张萍[1] 张峰[2] 李相成[2] 

机构地区：[1]南京医科大学一附院ICU,南京市210029 [2]南京医科大学一附院肝脏移植中心,南京市210029

出　　处：《临床麻醉学杂志》2005年第10期673-674,共2页Journal of Clinical Anesthesiology

摘　　要：目的探讨肝移植患者术后血清总胆红素及胆汁引流量对预后的影响。方法观察28例肝移植术后血清总胆红素及T管胆汁引流量的变化,分析其发生变化的原因,探讨处理方法,了解其对预后的影响。结果肝移植术后血清总胆红素逐渐升高,1周左右达到高峰(平均117.45μmol/L),其后开始下降;然而,T管胆汁引流量在术后逐步增加,10 d左右达高峰(达200 ml左右),并维持于较高水平;术前高胆红素血症、保存损伤以及急性排斥反应系术后高胆红素血症的主要原因。T管胆汁引流量在术后逐渐增多,平均在术后3 d达到100 ml;若总是低于50 ml并伴有胆红素增高,则预后欠佳。结论肝移植术后高胆红素血症和胆汁引流减少的的原因为保存损伤、排斥反应和术前高胆红素血症等。若总胆红素增高伴有T管引流量减少,则预后差。Objective To investigate the effect of early postoperative hyperbilirubinemia and T tube bile amount on the prognosis after liver transplantation. Methods In 28 cases of liver transplantation, hyperbilirubinemia and T tube bile amount after operation were monitored and analyzed. Results The total serum bilirubin（TB）level increased after liver transplantation, and reached at a peak level of 200 ml on the 10th postoperative day. Bile drainage less than 50 ml per day during 3 postoperative days indicated a poor prognosis. Conclusions The causes for hyperbilirubinemia and decreased bile drainage are preservative injury of donner,acute rejection,and preoperative hyperbilirubinemia. An increase of hyperbilirubinemia and a decrease of bile drainage after liver transplantation predict a poor prognosis.

关 键 词：肝移植 高胆红素血症 T管引流量 预后 血清总胆红素 肝移植术后 胆汁引流量 预后差 高胆红素血症 急性排斥反应 胆红素增高 保存损伤 肝移植患者 

分 类 号：R657.3[医药卫生—外科学]