摘要
目的 总结人工肝脏支持系统 (ALSS)应用于人体原位肝脏移植围手术期的经验体会。方法 回顾性分析 1993年 4月至 2 0 0 1年 5月连续实施的 5 5例肝脏移植中 9例病人在移植前后进行ALSS治疗的临床资料。结果 5 5例肝脏移植中有 9例病人在移植前和 (或 )后进行了 36例次的ALSS治疗。其中移植前有 8例病人进行共 2 4例次的ALSS治疗。原发疾病为慢性重型肝炎 4例 ,终末期肝硬化 4例。治疗后病人病情好转 ,肝功能等各项指标显著改善 ,顺利实施肝脏移植。移植术后 3例病人出现排斥反应 ,在调整免疫抑制剂方案同时辅以共 12例次的ALSS治疗 ,此后肝功能趋于好转 ,排斥反应得以扭转。结论 ALSS能纠正机体术前的内环境失衡 ,为供肝等待和增加手术耐受创造条件 ,应作为肝脏移植前积极准备的重要部分 ;ALSS为术后移植物功能发挥欠佳者提供了有力支持和恢复功能的机会。
Objective To report the experience of application of artificial liver support system(ALSS)during perioperative period of orthotopic liver transplantation(OLT). Methods The clinical data of 9 patients receiving ALSS treatment of totally 55 patients who underwent liver transplantation consecutively between April 1993 and May 2001 were analyzed retrospectively. Results Successful operation were achieved in all 55 cases,with the use of ALSS treatment in 9 patients for 36 times.For 8 patients suffering from chronic severe hepatitis or terminal liver cirrhosis,ALSS treatment enabled them to gain the opportunities to attain appropriate donor liver,and facilitated improvement of general conditions and tolerance to OLT.For 3 patients developing immune rejection postoperatively and accompanying with abnormal liver function,the adjusted immunosuppressive regimen combined with auxiliary ALSS therapy leaded to evident amelioration of donor liver function. Conclusion The timely application of ALSS provides necessary and valuable support to patients during perioperative period of OLT.Preoperative ALSS treatment should be applied actively as an important component of preparation for OLT,and postoperative ALSS treatmnet can give assistance to resume normal function of allograft.
出处
《中国实用外科杂志》
CSCD
北大核心
2002年第1期48-50,共3页
Chinese Journal of Practical Surgery
