自体肝移植技术治疗晚期肝泡型包虫病16例临床疗效分析  

The clinical effect of autologous liver transplantation in the treatment of advanced hepatic alveolar echinococcosis: a report of 16 case

作　　者：王燚 张宇 邓绍平[2] 杨冲[2] 杨洪吉 刘军[2] 周果[2] 先迪[2] WANG Yi;ZHANG Yu;DENG Shao-ping;YANG Chong;YANG Hong-ji;LIU Jun;ZHOU Guo;XIAN Di(Southwest Medical University Clinical Medicine College,Luzhou 646000,China;Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]四川省医学科学院.四川省人民医院,四川成都610072

出　　处：《实用医院临床杂志》2019年第3期59-63,共5页Practical Journal of Clinical Medicine

基　　金：四川省卫生计生委科研基金资助项目(编号:150192);四川省医学科学院.四川省人民医院临床研究及转化科研基金资助项目(编号:2017LY04)

摘　　要：目的探讨自体肝移植技术在治疗晚期肝泡型包虫病的疗效及安全性。方法回顾性分析本中心2017年8月至2018年11月收治的16例晚期肝泡型包虫病患者的临床资料,其中8例行半离体肝切除和8例行离体肝切除联合自体肝移植技术,分析患者的术中及术后随访情况。结果 16例患者手术时间(11. 5±3. 1) h,术中输血(8. 2±8) UU,术中失血(2253±842. 5) ml,术后住院时间(15±13) d。围手术期并发症6例,死亡1例;术后15例均随访,随访期间14例患者未见包虫复发及远处转移,1例术后5月死亡。结论自体肝移植是治疗晚期泡型包虫病的有效治疗方法,术中肝脏劈裂及个体化管道重建是手术的关键步骤,术前的精确评估、围手术期管理、手术方式非常重要。Objective To explore the safety and efficacy of the autologous livertransplantation(ALT)for advanced hepatic alveolar echinococcosis(HAE).Methods The clinical data of 16 adancede HAE patients from August 2017 to November 2018 were retrospectively analyzed.Among the patients,8 patients received semi-deteched hepatectomy and other 8 patients received exhepatectomy combined ALT,respectively.The intra-and post-operative data of the patients were analyzed.Results The operation time was 11.5±3.1 hours,the intro-operative blood trasfusion was 8.2±8 U,the average blood loss during surgery was 2253±842.5 ml and post-operative hospital stay is 15±13 days.The postoperative complications occured in 6 cases and 1 case died.After operation,15 patients were followed up.Of the patients,14 cases were found no recurrence or distant metastsis during follow-up time,and 1 case died after 5 months of operation.Conclusion ALT is effective for advanced HAE.Liver cleft palate and individual tube reconstruction is a critical step in surgery.Accurate evaluation before surgery,perioperative management and surgical options are significant for patient,s prognosis.

关 键 词：半离体肝切除 离体肝切除 自体肝移植 肝泡型包虫病 并发症 

分 类 号：R657.3[医药卫生—外科学]