半离体肝切自体余肝移植术后肝再生的研究  

Research on postoperative liver regeneration in patients underwent partly ex vivo hepatectomy and residual liver autotransplantation

作　　者：叶启发[1] 陈晚平[1] 明英姿[1] 任祖海[1] 佘兴国[1] 李珂[1] 

机构地区：[1]中南大学湘雅三医院湘雅移植医学研究院,长沙410013

出　　处：《中华实验外科杂志》2008年第7期857-859,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察半离体肝切自体余肝移植术后肝再生的规律及其代偿能力。方法通过CT计算5例半离体肝切自体余肝移植术后患者不同时间点的肝再生并监测术后肝脏功能变化。结果病例1、4的谷丙转氨酶（GPT）在术后第6、4天降至正常；病例2、3、5的GPT在术后10天左右降至正常水平。病例1术后2个月、1年肝体积再生率分别为21．62％、42．85％；病例2术后2个月、1年肝体积再生率分别为12．50％、61．84％；病例3术后2个月肝体积再生率为11．32％；病例4术后2个月肝体积再生率为25．98％；病例5术后2个月肝体积再生率为9．32％。结论该技术为难以常规肝切除的患者提供了可行性技术径路；术后残肝具有较强的再生能力，能满足机体代谢需要；尽量缩短肝脏冷缺血时间是减轻术后肝损伤，保护肝再生能力的关键。Objective To observe the postoperative compensatory and regenerative ability of residual liver in patients underwent partly ex vivo hepatectomy and liver autotransplantation. Methods Multi-slice spiral CT was taken to measure the residual liver volume of 5 cases after operation at different time and postoperative liver functions were monitored. Results The glutamic pyruvic transaminase （GPT） peak value of case NO 1 ,NO 4 were 527U/L,610U/L and got normal at 6 days,4 days respectively after operation ; The glutamic pyruvic transaminase （GPT） peak value of case NO 2, NO 3 and NO 4 were 2063 U/L,3231 U/L,2510 U/L respectively and turned normal at about 10 days after operation. The liver volume of case NO 1 after 2 month, 1 year were 859.40 cm3 ,1009.38 cm3 with liver volume regenerative rate 21.62% and 42.85% respectively;The liver volume of case NO 2 after 2 month,1 year were 603.41 cm^3 , 1029.89 cm^3 with regenerative rate 12.50% and 61.84% respectively;The liver volume regenerative rate of case NO 3 after 2 month was 11.32% ; The liver volume regenerative rate of case NO 4 after 2 month was 25.98% ;The liver volume regenerative rate of case NO 5 after 2 month was 9.32%. Conclusion Partly ex vivo hepatectomy and liver autotransplantation is an available technique for the patients whose tumor couldn＇ t be resected by traditional hepatectomy procedure ; Residual liver has strong regenerative ability after operation and can meet with the metabolic need of patients ; Shorting the cold ischemia time as far as possible during the operation is the key point to relieve the liver injury and protect the residual liver regenerative ability.

关 键 词：肝切除 自体肝移植 肝再生 

分 类 号：R657.3[医药卫生—外科学]