摘要
目的 :探讨伴有多器官功能不全病人进行肝移植手术的术式选择和围手术期处理要素。方法 :3例存在心肺功能不全、严重肝性脑病或肾功能不全的终末期肝病病人 ,通过积极的围手术期处理 ,在经典背驮式肝移植技术的基础上 ,改良供肝腔静脉与受体下腔静脉的吻合方式 ,完成经典供肝腔静脉 -受体左中肝静脉端端吻合术式 1例 ,供肝腔静脉 -受体下腔静脉端侧吻合 1例 ,供肝下腔静脉 -受体下腔静脉侧侧吻合 1例。结果 :3例均顺利完成手术 ,2例病人健在 ,存活期已超过 3个月 ,1例因严重曲霉菌感染于术后 16d死亡。结论 :改良背驮式肝移植术是抢救伴有多器官功能不全的终末期肝功能衰竭病人的有效手段 。
Objective:To explore the possiblility of liver transplantation for the patients of end-stage hepatic diseases with with multiple organ dysfunction and management elements after operaiton.Methods:Accommpanied with heart and lung dysfunction, severe hepatic coma or renal dysfunction, three cases with end-stage hepatic diseases were performed with piggyback liver transplantation after perfect treatment around the operative period. On basis of classical piggyback liver transplantation, anastomosis of donor's vena to recipient's inferior vena cava was modified, 1 case with end-end anastomsis of the donor′s vena cava to the receipt's left and median hepatic vein, 1 case with end-lateral anastomsis of the donor's vena cava to the receipt's vena cava, 1 case with lateral-lateral anastomsis of the donor's inferior vena cava to the receipt's inferior vena cava. Also the management methods and the developing tendency of liver function after operation were analyzed.Results:All the operations were successful.Two receipts were survial and living period have been beyond three months. The third cases died in 16 days after operation for severe Aspergillus infection. Conclusion: Piggyback liver transplantation is one of the life saving ways for end-stage hepatic diseases with multiple organ dysfunction. Modified piggyback liver transplantation had its advantages for benign end-stage hepatic diseases. and management elements after liver transplantation had its special laws. It was one of the key elements for operative success to pay respectful attention to treatment around the operative period.
出处
《中国现代医学杂志》
CAS
CSCD
2002年第8期3-6,共4页
China Journal of Modern Medicine
关键词
背驮式肝移植
多器官功能不全
围手术期处理
Piggyback Liver Transplantation
Multiple Organ Dysfunction
Treatment Around Operative Period
