高龄器官捐献供体肝移植临床效果观察  

Clinical effect of liver transplantation from elderly donors

作　　者：伏志[1] 赵晓飞[1] 许瀛[1] 支雨娜 栗光明 林栋栋[1] 王璐[1] Fu Zhi;Zhao Xiaofei;Xu Ying;Zhi Yu′na;Li Guangming;Lin Dongdong;Wang Lu(Department of General Surgery Center,Beijing You′an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院普外科中心,100069

出　　处：《国际外科学杂志》2021年第7期456-460,共5页International Journal of Surgery

摘　　要：目的探讨高龄器官捐献供体肝移植的临床效果。方法回顾分析2018年1月—2020年11月于首都医科大学附属北京佑安医院普外科中心行肝移植患者共346例临床数据,筛选后分为供者年龄60~70岁的高龄组30例及供者年龄<60岁的非高龄供体组60例。受者观察指标为:手术时间、无肝期时间、手术出血。预后指标为:术后ICU停留时间,住院时间,原发性移植物无功能(PNF),移植物功能延迟恢复(DGF)及住院病死率。符合正态分布的计量资料以均数±标准差(Mean±SD)表示,两组间比较采用t检验。不符合正态分布的计量资料以M(范围)表示,两组间比较采用Mann-Whitney U检验。计数资料采用χ2检验或Fisher′s精确检验分析。结果高龄组手术时间、无肝期时间、手术出血量分别为(444.33±72.44)min、56.0(30~170)min、1922.1(400~9000)mL,非高龄组分别为(460.88±91.32)min、58.45(35~140)min、1885.8(400~12000)mL,两组相比差异无统计学意义(P>0.05);预后指标中,高龄组ICU停留时间、住院时间及住院病死率分别为4.9(2~21)d、20.4(3~40)d、10%,非高龄组分别为5.3(1~32)d、22.1(3~61)d、10%,两组相比差异无统计学意义(P>0.05);两组均未发生PNF,但高龄组术后DGF发病率为13.33%(4/30),非高龄组为1.67%(1/60),两组相比差异有统计学意义(P<0.05)。结论在严格的供体术前评估及准确的受体选择下,60~70岁高龄供体用于肝移植,可取得与非高龄供体相似的近期疗效,但远期效果尚需进一步观察。Objective To investigate the clinical effect of liver transplantation from organ donors in elderly patients.Methods The clinical data of 346 patients who underwent liver transplantation in the general surgery center of Beijing You′an Hospital Affiliated to Capital Medical University from January 2018 to November 2020 were retrospectively analyzed.After screening,they were divided into the elderly donor group(30 cases)aged 60-70 years and the non elderly donor group(60 cases)aged<60 years.The observation indexes were operation time,anhepatic phase time and operation bleeding.The prognosis indexes were:postoperative ICU stay,length of hospital stay,primary graft nonfunction(PNF),delayed graft function recovery(DGF)and in-hospital mortality.The measurement data in accordance with normal distribution are expressed as(Mean±SD).The comparison between the two groups was analyzed by t-test.The measurement data that did not conform to the normal distribution were expressed as median(range).Mann Whitney U test was used for comparison between the two groups.The counting data were collected by the computerχ2 test or Fisher′s exact test analysis.Results The operation time,anhepatic period and blood loss in the elderly group were(444.33±72.44)min,56.0(30-170)min,1992.1(400-9000)mL,respectively and the non elderly group were(460.88±91.32)min,58.45(35-140)min,1885.8(400-12000)mL,respectively,there were no significant difference between the two groups(P>0.05);Among the prognostic indicators,the length of stay in ICU,the length of stay in hospital and the in-hospital mortality of the elderly group were 4.9(2-21)d,20.4(3-40)d and 10%respectively,while the length of stay in ICU,the length of stay in hospital and the in-hospital mortality of the non elderly group were 5.3(1-32)d,22.1(3-61)d and 10%respectively,with no significant difference between the two groups(P>0.05);No PNF occurred in the two groups,but the incidence rate of DGF in the elderly group was 13.33%(4/30),and the non elderly group was 1.67%(1/60).There was a s

关 键 词：活体供者 肝移植 高龄供体 器官捐献 

分 类 号：R657.3[医药卫生—外科学]