摘要
目的探讨肝移植时脾切除的适应证及对肝移植预后的影响。方法回顾性分析我院2001年1月至2006年4月期间施行的260例背驮式肝移植,肝移植时行脾切除者共28例(脾切除组),按1:2的比例随机抽取同期肝移植时未行脾切除者56例作为对照组,对比分析2组间的感染率、1年存活率及急性排斥反应发生率。结果脾切除组的感染率高于对照组(85.7% vs 55.4%,P<0.05),急性排斥反应发生率和1年存活率均明显低于对照组(3.6% vs 14.3%,P<0.05;46.4% vs 82.1%,P<0.05)。结论脾切除增加肝移植术后的感染率和死亡率,除非有明确的适应证,肝移植时不宜行脾切除。
Objective To explore the effect and indication of splenectomy in liver transplantation. Methods From January 2001 to April 2006, 260 patients underwent piggyback orthotopic liver transplantation （PBOLT）, and 28 patients had undergone combined PBOLT and splenectomy （splenectomy group）. These patients were compared to 56 randomly selected non-splenectomy patients from the same transplant period, meaningly two controls were selected for every non-splenectomy case. Two groups were analyzed with respect to rate of infection and survival rate, as well as biopsy-proven acute allograft rejection within 30 days after transplantation. Results Rate of infection in the splenectomy group was higher than that in the non-splenectomy patients （85.7% vs 55.4%, P〈0.05）. Acute rejection and survival rates in the splenectomy group were lower than those in the non-splenectomy patients （3.6% vs 14.3%, P〈0.05; 46.4% vs 82.1%, P〈0.05）. Conclusion Concomitant splenectomy with PBOLT has a significantly higher patient mortality rate; it is mainly due to its septic complications. At present, unless there is a certain indication for splenectomy, this procedure is not recommended.
出处
《中国普外基础与临床杂志》
CAS
2008年第3期159-161,共3页
Chinese Journal of Bases and Clinics In General Surgery
基金
卫生部部属临床学科重点项目基金(编号:98040362)
关键词
肝移植
脾切除
急性排斥反应
脓毒血症
Liver transplantation Splenectomy Acute rejection Sepsis
