背驮式和经典式肝移植术对肾功能影响的观察(附28例分析)  

Influence of piggyback orthotopic liver transplantation on the kidney function:analysis of 28 cases

作　　者：杨代和[1] 朱玉玲[1] 刘翔 张宏林[1] 谈景旺[1] 郑秀如[1] 

机构地区：[1]福建中医学院附属第二人民医院,350003 [2]闽清县六都医院,350811

出　　处：《福建医药杂志》2006年第2期7-9,共3页Fujian Medical Journal

摘　　要：目的通过比较背驮式和经典式肝移植病人术中及术后肾血流和肾功能的变化,对肝移植病人肾功能保护提供理论依据。方法收集重症肝炎、肝硬化病人28例,分成背驮式肝移植组(A组,n=14)和经典式肝移植组(B组,n=14),采用气管插管静吸复合全麻。分别于开腹前(T0)、无肝期30min(T1)、新肝期10min(T2)、术毕(T3),术后24h(T4),由专人用彩色多普勒B超测量肾动脉的血流速度,并根据以下公式计算阻力系数(RI)。从SwanGanz导管抽取右心房血测Bun和Cr水平,于手术各时期抽取动脉血测定酸碱度和电解质,同时记录尿量。结果两组病人在无肝期之前肾动脉RI、尿量、Bun、Cr水平差异无统计学意义(P>0.05),在其余各时期A组优于B组(P<0.05),B组T4、血Bun和Cr有改善趋势。结论背驮式与经典式肝移植比较,术中血流动力学较稳定,肾血管阻力系数增加不明显,肾小球滤过率无下降,肾功能得到较好保护。Objective To investigate the different effects on the kidney blood and the kidney tunction in piggybak and classic orthotopic liver transplantation. Methods The clinical data of 28 cases with advanced hepatitis and hepatocirrhosis were divided into piggyback orthotopic liver transplantation group （Group A） and classic orthotopic liver transplantation group （Group B） . The renal function and renal artery resistence index after the operation were compared. Results There were no notable differences in kidney artery RI, levels of Bun and Cr, and the total urinary between the two groups before anhepatic phase （P〉0. 05）, but the same indexes of Group A in the following stages were improved （P〈0. 05）. Conclusion The piggyback orthotopic liver transplantation is advantaged to improve the renal function of the patients undergoing liver transplantation.

关 键 词：肝移植 肾血流 肾功能 

分 类 号：R657.3[医药卫生—外科学]