肝移植治疗晚期肝硬化伴门静脉高压症18例  

Liver transplantation in treating end-stage liver cirrhosis complicated by portal hypertension: A report of 18 cases

作　　者：江艺[1] 吕立志[1] 胡还章[1] 张绍庚[1] 张小进[1] 陈永标[1] 张坤[1] 杨芳[1] 魏为明[1] 潘凡[1] 蔡秋程[1] 陈少华[1] 

机构地区：[1]全军器官移植中心,解放军南京军区肝胆外科研究所,福州总医院肝胆病中心肝胆外科,全军器官移植中心,福建省福州市350025

出　　处：《中国组织工程研究与临床康复》2007年第34期6872-6873,共2页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察肝硬化伴门静脉高压症患者肝移植术后的随访结果。方法:选择2000-01/2006-12在福州总医院肝胆病中心肝胆外科行肝移植的晚期肝硬化伴门静脉高压症患者18例,患者均知情同意。12例行经典原位肝移植,6例行背驮式肝移植。平均手术时间(12±4)h,平均输血量(7000±400)mL。所有病例术后病理证实均为弥漫性结节型肝硬化,术后均用FK506和激素二联免疫抑制剂治疗方案。结果:①无术中死亡,手术成功率100%。围手术期死亡3例,其余15例患者出现围手术期并发症13例次。②15例存活患者均获随访,肝功能恢复良好,术后未见上消化道大出血复发。其中12例患者生存超过半年,5例患者已过1年。结论:肝移植是治疗晚期肝硬化伴门静脉高压症的有效方法,结合患者病情,合理选择外科治疗方案对患者的愈后尤为重要。AIM： To observe the follow up of patients with liver cirrhosis complicated by portal hypertension after liver transplantation. METHODS： Eighteen patients with end-stage liver cirrhosis complicated by portal hypertension, who underwent liver transplantation in Department of Hepatobiliary Surgery, Hepatobiliary Center of Fuzhou General Hospital, were selected from January 2000 to December 2006 with informed consent. Of them, 12 cases were treated with classic orthotopic liver transplantation, and 6 with piggyback liver transplantation, average time of （12±4） hours, and blood transfusion volume of （7 000±400） mL. All cases were identified as diffuse nodular cirrhosis by pathology, and treated with FK506 and hormone immune depressant after operation. RESULTS： Operative achievement ratio was 100% without operative death. Three patients died perioperatively, and 15 patients got complications during operation. ②All 15 survivals were followed up. Their live function recovered well, and no relapse of massive hemorrhage of upper gastrointestinal tract was found. Twelve patients ha.d survived for more than 6 months and 5 have lived more than 1 year. CONCLUSION： Liver transplantation is an available treatment for end-stage liver cirrhosis complicated by portal hypertension. To select appropriate surgical therapy based on their disease condition is significantly important for patients.

关 键 词：肝移植 肝硬化 高血压 门静脉 器官移植 

分 类 号：R657.3[医药卫生—外科学]