肝移植治疗原发性胆汁性肝硬化的近期疗效  

Short-term efficacy of liver transplantation for primary biliary cirrhosis

作　　者：邢同海[1] 彭志海[1] 陈国庆[1] 徐军明[1] 钟林[1] 

机构地区：[1]上海交通大学第一人民医院普外科上海市器官移植中心,上海200080

出　　处：《上海交通大学学报（医学版）》2007年第6期735-738,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科技发展基金(02411960)~~

摘　　要：目的分析肝移植治疗原发性胆汁性肝硬化（PBC）的近期疗效。方法2001年10月-2006年2月,接受肝移植手术的PBC患者共17例,平均年龄（49.6±6.6）岁。回顾患者住院期间及随访期的资料,根据Mayo公式计算患者保守治疗的1a预计生存率。观察患者术后临床特征、复发和生存情况,分析死亡原因;计算移植后患者实际生存率,并与1a预计生存率比较。结果本组患者平均随访时间（28.8±15.7）月;移植后患者症状迅速缓解、肝功能改善。移植后0.5、1、2a的实际生存率分别为100%、100%、83.3%。生存分析显示,本组患者1a实际生存率显著高于保守治疗的1a预计生存率（77%）（P=0.006）;17例中仅1例患者移植15个月后,经肝活检证实PBC复发,移植18个月后因继发胆管炎、感染性休克死亡。结论肝移植可提高终末期PBC患者的生活质量,延长其生存时间。Objective To analyse the short-term efficacy of liver transplantation for primary biliary cirrhosis （ PBC）. Methods From Oct 2001 to Feb 2006, 17 patients were performed liver transplantation with an average age of （49.6 ± 6.6） years. The clinical data during the hospital stay and follow up were retrospectively analysed, and one-year predicted survival rate of conservative treatment was calculated according to the Mayor model. The clinical manifestation, recurrence and survival conditions were observed, and the cause of death was analysed. The actual survival rate was calculated and compared with the one-year predicted survival rate. Results The mean time of follow-up was （28.8 ±15.7） months. The symptoms were soon relieved and liver function was improved after transplantation. The actual half, one, and two-year survival rates after transplantation were 100% , 100% and 83.3% , respectively. The survival analysis revealed that the one-year survival rate of the patients with transplantation was significantly higher than those with the conservative treatment （77%） （P =0. 006）. Only one patient with PBC experienced recurrence confirmed by liver biopsy 15 months after transplantation, and was dead 3 months later due to secondary cholangitis and septic shock. Conclusion Liver transplantation can improve quality of life and extend survival time of patients with end-stage PBC.

关 键 词：肝移植 肝硬化 胆汁性 生存时间 

分 类 号：R657.3[医药卫生—外科学]