摘要
目的:观察10例原位肝移植患者术后并发症的发生及诊治情况。方法:选择2001-04/2005-07在安徽省淮北市人民医院肝胆外科行原位背驮式肝移植的患者10例,患者均知情同意。术后加强重要脏器的功能监测,早期应用免疫抑制剂。术后定期随访,测定肝肾功能、血常规、血生化、病毒载量及免疫药物剂量,复查肝脏彩超,采用内镜技术和介入疗法诊疗肝移植术后并发症。结果:①10例患者肝移植手术均获得成功。②术后并发症:腹腔内出血1例,胃肠道出血1例,急性排斥反应1例,慢性排斥反应1例,肺部感染、胸腔积液2例,腹腔感染、左膈下脓肿1例,真菌感染1例,下腔静脉狭窄1例,胆管吻合口漏并胆管狭窄1例,胆管狭窄并胆泥形成1例,胆管吻合口狭窄1例,乙肝复发1例。③10例患者中死亡2例,术后1个月肝癌腹腔广泛转移自动出院1例,存活7例。7例患者均获随访,随访时间分别为65,60,43,36,28,24,21个月。随访结束时7例患者均健康生存,其中1例存活已超过5年5个月,且正常妊娠分娩,新生儿生长发育良好(已超过3周岁)。结论:对肝移植术后并发症的及时诊断和有效治疗是提高肝移植术后成功率的关键。
AIM： To investigate the diagnosis and treatment of postoperative complications in 10 patients undergoing orthotopic liver transplantation （OLT）.
METHODS： From April 2001 to July 2005, 10 patients received modified piggyback liver transplantation in Huaibei People＇s Hospital in Anhui province. All the cases were informed of and agreed with the treatment scheme. The function monitoring of vital organs was enhanced, immunosuppressive agent was used early and the patients were examined periodically. Inspecting indexes included liver function, renal function, routine hematological examination, blood biochemical cnterion, virus load, drug concentration and liver Color Doppler Ultrasound. Endoscope technique and intervention therapy were applied to detect the complication after OLT.
RESULTS： （1）AII 10 cases were successful for OLT. （2）Complications after OLT included： intra-abdominal bleeding in 1 case, gastrointestinal bleeding in 1 case, acute rejection in 1 case, chronic rejection in 1 case, pulmonary infection and/or pleurorrhea in 2 cases, abdominal infection and/or left subphrenic abscess in 1 case, fungous infection in 1 case, infedor vena caval stncture in 1 case, bUiary stomal leak complicated with biliary stricture in 1 case, biliary stricture complicated with the formation of bUiary sludge in 1 case, biliary stoma stricture in 1 case, and hepatitis B viral infection in 1 case.（3）Among 10 cases, 2 died, 1 was discharged due to extensive transferring to abdominal cavity of liver cancer, 7 patients were alive and followed up for 65, 60, 43, 36, 28, 24, 21 months respectively. And one case survived for 5 years and 5 months, with a 3-year healthy child.
CONCLUSION： Timely diagnosis and treatment are essential to prevent the complications after OLT.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第25期4992-4994,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
安徽省淮北市科技局科研基金项目(021036)~~
