肝移植治疗因停用核苷类似物导致的慢加急性肝衰竭17例临床观察  

Clinical observation of liver transplantation in the treatment of 17 cases of acute-on-chronic liver failure induced by discontinuation of nucleoside analogues

作　　者：张骊[1] 张炜琪 谢炎 宋红丽[1] 田大治[1] 李俊杰[1] 孙纪三[1] 谭玉莹 蒋文涛[1] Zhang Li;Zhang Weiqi;Xie Yan(Department of liver Transplantation,Tianjin first Central Hospital,Tianjin Key Laboratory of Organ Transplantation,Tianjin Clinical Medical Research Center of Organ Transplantation,Key Laboratory of Transplantation Medicine,Chinese Academy of Medical Sciences,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院肝移植科,天津市器官移植重点实验室,天津市器官移植临床医学研究中心,中国医学科学院移植医学重点实验室,天津300192

出　　处：《实用器官移植电子杂志》2021年第1期46-49,共4页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：国家自然科学基金面上项目(81870444);天津市自然科学基金(19JCQNJC10300)。

摘　　要：目的探讨肝移植治疗因停用核苷类似物(nucleoside analogues,NAs)导致慢加急性肝衰竭患者的临床疗效。方法回顾性分析并总结2017年9月—2019年12月间天津市第一中心医院接受肝移植治疗的17例因停用NAs导致慢加急性肝衰竭患者的术前、术后临床资料。结果17例患者手术均获成功,术后28 d生存率100%,术后3个月生存率94.12%,术后1年生存率为94.12%。结论慢性乙肝患者盲目停用核苷类似物,可能会导致肝功能衰竭的发生,对于停用NAs导致慢加急性肝衰竭的患者,肝移植是一种有效的治疗手段,术后持续抗病毒治疗至关重要。Objective To investigate the clinical efficacy of liver transplantation in the treatment of patients with acute-on-chronic liver failure induced by discontinuation of nucleoside analogues(NAs).Methods The preoperative and postoperative clinical data of 17 patients with acute-on-chronic liver failure induced by discontinuation of NAs in Tianjin First Central Hospital from September 2017 to December 2019 were retrospectively analyzed and summarized.Results All the 17 patients were operated successfully,with a 28-day survival rate of 100%,a 3-month survival rate of 94.12%,and a 1-year survival rate of 94.12%.Conclusion Blind withdrawal of NAs in patients with chronic hepatitis B may lead to liver failure.Liver transplantation is an effective treatment for patients with acute-on-chronic liver failure induced by discontinuation of NAs.Continuous antiviral therapy after operation is very important.

关 键 词：肝移植 慢加急性肝衰竭 停用核苷类似物 预后 

分 类 号：R657.3[医药卫生—外科学] R575.3[医药卫生—临床医学]