血管闭合系统在肝移植门静脉重建中的应用分析:附137例报道  

Analysis on the application of vascular closure system in portal vein reconstruction of liver transplantation:report of 137 cases

作　　者：潘冰[1] 吕少诚[1] 李立新[1] 赵昕[1] 张志华[1] 李平[1] 郎韧[1] 贺强[1] Pan Bing;Lyu Shaocheng;Li Lixin;Zhao Xin;Zhang Zhihua;Li Ping;Lang Ren;He Qiang(Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital Affliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院肝胆外科,北京100020

出　　处：《器官移植》2018年第4期255-260,共6页Organ Transplantation

基　　金：国家自然科学基金(81471590)

摘　　要：目的分析非穿透性血管闭合系统在成人同种异体肝移植门静脉重建中的应用效果。方法回顾性分析222例同种异体肝移植患者的临床资料。根据术中门静脉重建是否使用血管闭合系统,分为血管夹组(137例)和传统缝合组(85例)。比较两组患者围手术期情况、预后情况和并发症发生情况。结果两组患者均顺利完成手术,血管夹组一次性吻合门静脉的成功率为93.4%(128/137)。本组资料中共有14例患者围手术期死亡,病死率为6.3%(14/222),两组患者围手术期均未发生门静脉相关并发症。血管夹组的门静脉吻合时间为(5.6±1.7)min,明显短于传统缝合组的(10.7±3.6)min,差异有统计学意义(P<0.05)。两组患者围手术期并发症发生率及分级比较,差异均无统计学意义(均为P>0.05)。结论肝移植术中使用血管闭合系统重建门静脉是安全可行的,与传统手工缝合比较,前者能有效缩短门静脉吻合时间。Objective To analyze the application effect of non-penetrating vascular closure system in portal vein reconstruction of allogenic liver transplantation in adults. Methods Clinical data of 222 patients undergoing allogeneic liver transplantation were retrospectively analyzed. According to whether vascular closure system was used in portal vein reconstruction during operation, all patients were divided into vascular clip group（n=137） and traditional suture group（n=85）. Perioperative conditions, clinical prognosis and complications were statistically compared between two groups. Results All patients successfully completed the surgery. The success rate of one-time portal vein anastomosis was 93.4%（128/137） in the vascular clip group. A total of 14 patients died during perioperative period in this study with a mortality rate of 6.3%（14/222）. No portal vein-related complications occurred during perioperative period in both groups. The time of portal vein anastomosis in the vascular clip group was（5.6±1.7） min, which was significantly shorter than（10.7±3.6） min in the traditional suture group（P〈0.05）. The incidence and grade of perioperative complications did not significantly differ between two groups（all P〈0.05）. Conclusions It is safe and feasible to utilize vascular closure system to reconstruct the portal vein during liver transplantation. Compared with traditional suture, it can effectively shorten the time of portal vein anastomosis.

关 键 词：血管闭合系统 传统缝合 同种异体原位肝移植 门静脉 血管吻合 手术时间 围手术期并发症 血栓 

分 类 号：R617[医药卫生—外科学]