肝移植联合特利加压素治疗肝肾综合征的疗效分析  

Efficacy analysis of liver transplantation combined with terlipressin in the treatment of hepatorenal syndrome

作　　者：胡鸿贵 戴清清[1] 赵红川[1] HU Honggui;DAI Qing-qing;ZHAO Hong-chuan(Department of Hepatopancreatobiliary Surgery,the First Afiliated Hospital of Anhui Jniversity,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院肝胆胰及移植外科一病区,合肥230022

出　　处：《肝胆外科杂志》2025年第1期24-27,共4页Journal of Hepatobiliary Surgery

基　　金：安徽省临床医学研究转化专项(202204295107020015)。

摘　　要：目的探究肝移植联合特利加压素与单纯特利加压素治疗肝肾综合征患者的临床疗效。方法回顾性分析安徽医科大学第一附属医院2017年1月至2023年12月14例术前存在肝肾综合征的肝移植联合围手术期特利加压素治疗患者及41例消化内科行特利加压素治疗肝肾综合征患者的临床资料。监测指标包括治疗后肾功能变化和短期生存率。结果两组患者在治疗后第1天、第3天、第1周、第2周血肌酐值无统计学差异(P>0.05)。2周后特利加压素组患者血肌酐值进行性升高,肾功能持续恶化。然而肝移植联合特利加压素组患者2周后肝肾功能逐渐恢复,血肌酐值逐渐恢复到正常范围内。肝移植联合特利加压素组1年生存率明显优于特利加压素治疗组(92.8%vs63.4%,P=0.046)。结论肝移植联合特利加压素治疗对比特利加压素治疗能够有效改善肝肾综合征患者肾功能并提高短期生存率。Objective To explore the clinical efficacy of liver transplantation combined with terlipressin and simple terlipres-sin in the treatment of patients with hepatorenal syndrome.Methods The clinical data of 14 patients with hepatorenal syndrome before liver transplantation combined with perioperative terlipressin treatment and 41 patients with hepatorenal syndrome treated with terlipres-sin in the First Affiliated Hospital of Anhui Medical University from January 2017 to December 2023 were retrospectively analyzed.Mo-nitoring indicators included changes in renal function after treatment and short-term survival rates.Results There were no significant differences in serum creatinine between the two groups on the first day,the third day,the first week and the second week after treat-ment(P>0.05).After 2 weeks,the serum creatinine value of the patients in the terlipressin group increased progressively,and the renal function continued to deteriorate.However,the liver and kidney function of the patients in the liver transplantation combined with teripressin group gradually recovered after 2 weeks treatment,and the serum creatinine value gradually returned to the normal range.The 1-year survival rate of liver transplantation combined with terlipressin group was significantly higher than that of terlipressin group(92.8%vs 63.4%,P=0.046).Conclusion Compared with terlipressin treatment,liver transplantation combined with terlipressin treatment can effectively improve the renal function and short-term survival rate of patients with hepatorenal syndrome.

关 键 词：月肝移植 特利加压素 终末期肝病 肝肾综合征 

分 类 号：R575[医药卫生—消化系统]