肝移植后乙肝复发继发结核播散1例  

Hepatitis B recurrence and secondary tuberculosis dissemination after liver transplantation in one case

作　　者：李俊 陈虹 范铁艳 王旭 

机构地区：[1]武装警察部队总医院移植研究所,北京市100030

出　　处：《中国组织工程研究》2012年第31期5881-5885,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:肝移植后在乙型肝炎复发导致肝功能衰竭的基础上继发结核播散,病情进展迅速,且有治疗矛盾。目的:总结1例肝移植后乙型肝炎复发继发结核播散患者的诊治要点及预后。方法:收集武装警察部队总医院收治的1例肝移植后乙型肝炎复发致肝功能衰竭并继发结核播散患者的临床资料及诊治过程,并回顾性分析迄今见于文献报道的国内外关于肝移植后乙型肝炎复发和结核播散的原因、诊断手段、治疗方法和预后。结果与结论:该患者肝移植后乙型肝炎复发时,抗结核治疗尚未完成疗程,虽在治疗上尽量兼顾乙型肝炎复发及结核播散,患者仍死亡。结果显示,肝移植后乙型肝炎复发导致肝功能衰竭的基础上继发结核播散,病情进展迅速,预后极差,治疗过程中要兼顾二者,必要时停用免疫抑制剂。BACKGROUND： The dissemination of tuberculosis based on hepatic failure because of hepatitis B recurrence after liver transplantation progresses rapidly and there is a contradictory on its treatment. OBJECTIVE： To summarize the diagnosis, treatment and prognosis of one patient with hepatic failure caused by hepatitis B recurrence after liver transplantation and secondary tuberculosis dissemination. METHODS： We collected the clinical data of one patient with hepatic failure caused by hepatitis B recurrence and secondary tuberculosis dissemination after liver transplantation in General Hospital of Chinese People＇s Armed Police Forces. A retrospectively analysis of the cause, diagnosis, therapeutic method and prognosis of the patients with hepatitis B recurrence or tuberculosis dissemination after liver transplantation reported at home and abroad were preformed. RESULTS AND CONCLUSION： The treatment for tuberculosis was not completed when hepatitis B recurrent after liver transplantation. Although we tried to finish the treatment for tuberculosis as well as curing hepatitis B, the patient still died The result shows that the dissemination of tuberculosis based on hepatic failure because of hepatitis B recurrence after liver transplantation progresses rapidly and the prognosis is poor. We should find a balance point between them on the treatment, and stop using immunosuppressive agent necessarily.

关 键 词：乙型肝炎复发 肝移植 结核 诊断 治疗 预后 

分 类 号：R617[医药卫生—外科学]