临床腹部多器官联合移植术中血液生化的改变  

Biochemical changes during the clinical abdominal multivisceral transplantation

作　　者：朱玮冰[1] 李朝龙[1] 黄玫[1] 林建华[1] 林智琪[1] 周占春[1] 

机构地区：[1]第一军医大学南方医院

出　　处：《中国普通外科杂志》1997年第6期325-328,共4页China Journal of General Surgery

摘　　要：通过对腹部多器官联合移植（ＡＭＶＴ）术中监测，发现血液生化改变以酸血症、高血糖、低血钾、高血磷、总胆汁酸升高和尿酸降低为主。ＡＭＶＴ术中的血液生化改变主要是由于阻断下腔静脉和无内脏（肝、胰）引起的代谢紊乱所致，应激状态、大量输血、补液补碱、使用激素、创伤引起的高分解代谢均有一定影响。提示：术中注意补钙补碱，合理使用胰岛素，排放掉移植器官最初的循环血液，尽量缩短无内脏期，可减轻血液生化的变化；采用静脉静脉转流，术中适当补钾可能对患者有益。The biochemical changes of the patient who underwent an abdominal multivisceral transplantation (AMVT) were detected. It was discovered that the primary disorders, including acidosis, high levels of serum sugar, phosphorus and total bile acid as well as low levels of serum potassium and uric acid, were mainly caused by block of the inferior vena cava and the anviscera (liver and pancreas). However, use of cortison, strees, large quantity blood transfusion and saline infusion also resulted in biochemical disorders during AMVT. To reduce the changes, we adopted the following management: sodium bicarbonate solution and calcium infusion in time; using insulin properly; discharging the circulation blood just after the transplanted organs reperfused; reduce the time of anviscera phase to the minimum. Performing a venovenous bypass and appropriate potassium infusion during the operation might be useful to the patient.

关 键 词：腹部 器官移植 血液生化 AMVT 

分 类 号：R656[医药卫生—外科学]