活体部分肝移植12例次临床报告  

A clinical report of 12 case-times of living related liver transplantation

作　　者：王学浩[1] 张峰[1] 李相成[1] 钱建民[1] 孔连宝[1] 黄峻[1] 黄祖瑚[1] 张浩[1] 李国强[1] 成峰[1] 王科[1] 陆森[1] 

机构地区：[1]南京医科大学第一附属医院肝脏外科江苏省肝脏移植中心,210029

出　　处：《中华医学杂志》2002年第7期435-439,共5页National Medical Journal of China

基　　金：江苏省重点科研课题基金 (BJ980 2 5 );江苏省青年科研课题基金 (BQ980 12 );江苏省卫生厅科研基金 (4 5 5EA95 0 2 )

摘　　要：目的　探讨总结活体原位部分肝移植技术的临床应用。方法　通过回顾性临床分析 ,总结 12例次 (11例 )活体原位部分肝移植的手术技术和体会、围手术期主要处理经验和并发症诊疗 ,并对活体肝移植的适应证、手术时机、外科并发症 ,以及感染、排斥、优点等相关临床问题进行探讨。结果　本组资料中 ,11例供体术后顺利康复 ,均未出现严重并发症 ;第 1例受体死亡 ,10例肝豆状核变性受体获得长期健康生存 ,现已分别存活 5 8周、5 1周、4 8周、38周、37周、36周、2 2周、18周、10周和 7周 ;目前 ,所有存活受体未发现明确免疫排斥 ;其肝功能、铜氧化酶水平均已恢复正常。其中 ,6例受体已经康复上学 ;2例康复出院 ;其余 2例在顺利康复中。术后主要并发症以血管并发症、胆道并发症、细菌及病毒感染和肺部并发症为主。结论　活体原位部分肝移植手术过程复杂 ,涉及供、受体双方安全 ,技术要求高 ,难度大。该技术具有供肝来源广泛、供肝质量高和费用相对较低等优点 ,有广阔的临床应用前景。Objective To evaluate and summarize the clinical application of living related liver transplantation (LRLT) Methods A retrospective analysis was made in altogether 12 LRLT operations of living related liver transplantation performed in our department The indication and timing, surgical complications, and nonsurgical issues including infection, rejection, advantages of LRLT in our series were reviewed Result All the 11 donors are uneventfully after operation; the first receptor was dead, and 10 receptors with Wilson′s disease achieve long term survival The postoperative survival time till now is 58 w?51 w?48 w?38 w?37 w?36 w?22 w?18 w?10 w and 7 w, respectively No rejection was detected in the recipients with Wilson′s disease, whose liver function and cuprum oxidase level had returned to normal In this 10 cases, 6 of them has returned or gone to school, 2 of them were discharged from hospital, 2 of them has been recovered smoothly in the hospital due to short time postoperatively The primary complications after operation including blood vessel, biliary tract, lung and the infection of microbe or virus, were mainly involved in our series Conclusion The process of operation was complicated; the operation technology was exigent and difficult with respect to the safety of the donors and receptors LRLT has capacious clinical application for there are many unsurpassable advantages, such as plentiful resource and fine quality of graft liver, lower cost of LRLT

关 键 词：肝移植 肝豆状核变性 活体部分肝移植 并发症 诊断 治疗 病例报告 

分 类 号：R657.3[医药卫生—外科学]