活体部分肝移植、全肝移植的临床研究(附22例报告)  

A Retrospective Study on 22 Cases of Liver Transplantation

作　　者：王学浩[1,2] 张峰[1,2] 李相成[1,2] 钱建民[1,2] 孔连宝[1,2] 成峰[1,2] 张浩[1,2] 李国强[1,2] 孙倍成[1,2] 王科[1,2] 刘军[1,2] 范永刚[1,2] 陆森[1,2] 钱晓峰[1,2] 

机构地区：[1]南京医科大学附属第一医院肝脏外科 [2]江苏省肝脏移植中心,210029

出　　处：《外科理论与实践》2002年第2期125-127,共3页Journal of Surgery Concepts & Practice

基　　金：江苏省重点项目基金资助(BJ98025)

摘　　要：目的：总结临床肝移植的经验。方法：对１０例活体部分肝移植（包括一例活体肝移植肝动脉栓塞后施行减体积肝移植）和１２例全肝移植的临床资料进行回顾性分析。结果：全组存活２１例，一例原位肝移植死于多脏器功能衰竭。乙型肝炎病人采用拉米夫定加小剂量ＨＢＩｇ治疗，１０例病人术后随访１～１３月，复查发现Ｋ－Ｆ环有不同程度变浅。术后并发症：腹腔出血２例，需再次剖腹探查止血；ＡＲＤＳ５例；急性排斥的反应一例；急性肾功能衰竭一例。结论：肝移植是治疗终末期肝病的有效方法。完善的手术技术和正确的围手术期处理是肝移植成功的关键，活体部分肝移植是缓解供肝短缺问题又一方向。Objective:To review our clinical experience of liver transplantation. Methods:A retrospective study was made for 10 cases of LRLT(living related liver transplantation) (including one case of reduced size liver transplantation) and 12 cases of OLT(orthotopic liver transplantation). Results:Recovery of the graft function was satisfactory in 21 patients, 1 patient died of ARDS. In 10 cases, hepatitis B was treated with Lamivudine and lose dose HBIg; these cases were HBV-DNA negtive in 1～13 months postoperatively. In 12 cases of Wilson＇s disease, copper oxidase and ceruloplasmin turned normal and the Kayser-Fleischer ring faded in varying degress. The postoperative complications included intra-peritoneal hemorrhage in 2 cases, ARDS in 5, acute rejection in 1 and acute renal failure in 1. Conclusions:Liver transplantation is an effective therapeutic option for end-stage liver diseases. Justly conducted surgery and perioperative management are key points for the success of liver transplantation. Living related liver transplantation is represents another commendable choice in view of the shortage of donors in China.

关 键 词：活体部分肝移植 原位肝移植 并发症 手术方法 

分 类 号：R657.3[医药卫生—外科学]