儿童肝移植肝动脉重建技术分析  

Reconstruction of hepatic artery in liver transplantation in children

作　　者：沈丛欢 陶一峰 李瑞东 马震宇 张全保 李建华 王正昕 SHEN Cong-huan;TAO Yi-feng;Li Rui-dong(Department of General Surgery,Affiliated Huashan Hospital of Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院普外科,上海200040

出　　处：《肝胆外科杂志》2019年第6期416-418,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨儿童肝移植术中肝动脉的重建技术,比较活体部分和心脏死亡器官捐献(DCD)全肝肝动脉重建区别,以降低肝动脉栓塞的发生率,提高患儿生存率。方法回顾性分析2014年9月至2019年9月间实施的138例儿童肝移植临床资料,其中活体肝动脉显微重建采用10倍显微镜下的显微外科重建技术,DCD全肝移植采用2.5倍放大镜重建,术后采用彩色多普勒超声监测肝动脉血流,分别观察其术后发生肝动脉栓塞并发症的情况结果138例儿童肝移植中100例为活体部分肝移植,38例为DCD供肝移植。两组均无术后肝动脉栓塞的病例发生。结论熟练应用肝动脉重建技术能降低儿童肝移植术后肝动脉栓塞发生率,取得满意效果。Objective To explore the reconstruction technique of hepatic artery in childrens liver transplantation,and to compare the difference between the whole hepatic artery reconstruction of living part and that of cardiac dead organ donation(DCD),so as to reduce the incidence of hepatic artery embolism and improve the survival rate of children.Methods The clinical data of 138 cases of liver transplantation in children from September 2014 to September 2019 were analyzed retrospectively.Among them,the microsurgical reconstruction of living hepatic artery was performed under 10 times microscope,the reconstruction of DCD whole liver transplantation was performed under 2.5 times magnifying glass,the blood flow of hepatic artery was monitored by color Doppler ultrasound,and the complications of hepatic artery embolism were observed.Results Among 138 cases of liver transplantation in children,100 cases were living donor liver transplantation and 38 cases were DCD donor liver transplantation.There was no postoperative hepatic artery embolism in both groups.Conclusion Skilled application of hepatic artery reconstruction technology can reduce the incidence of hepatic artery embolism after liver transplantation in children and achieve satisfactory results.

关 键 词：肝动脉栓塞 儿童肝移植 显微外科 

分 类 号：R575[医药卫生—消化系统]