摘要
目的 探讨同种原位肝移植术中先行转流,再游离肝脏这一技术改进的可行性及优越性。方法 回顾性分析近3年来连续施行的46例原位肝移植术,前期23例（前期组）按经典式方法先游离肝脏后转流,后期23例（后期组）先转流再游离肝脏,分析比较两组转流时间、无肝期长短、失血量等指标以及术后恢复过程、并发症及预后等。结果 前期组和后期组的转流时间分别为（99.78±21.6）min及（96.32±22.25）min,无肝期时间分别为（100.00±21.19）min及（102.00±24.31）min（P>0.05）,而术中失血量则为（5096±4243）ml及（1726±1125）ml,（P<0.01）。术后前期组发生并发症26例次,死亡3例,后期组发生并发症13例次,无死亡。结论 先转流后游离肝脏,不增加转流时间及无肝期时间,但能显著减少术中出血量,有助于术后恢复及减少并发症,特别适用于终末期肝硬化患者及肝癌患者的肝移植术。
To investigate the possibility and safety of the new technique of venovenous bypass prior to mobilization of liver in orthotopic liver transplantation (OLTx). Methods A retrospective analysis was made for 46 cases of OLTx performed in recent three years. The early period group consisted of 23 cases of OLTx underwent classical approach of mobilization of liver first followed by venovenous bypass. Twenty-three cases in the late period group underwent the new approach of venovenous bypass first. Statistical analysis was made for bypass time, nonhepatic period time, blood loss and postoperative clinical course, complications and prognosis between two groups. Results In the early period group and late period group, the bypass time was (99.78±21.36) min and (96.32±22.25) min, the nonhepatic period was (100.00±21.19) min and (102.00±24. 31) min, respectively (P > 0.05). The intraoperative blood loss was (5 096±4 243) ml in the early period group and (1 726±1 125) ml in the late period group (P< 0. 01). The postoperative complications and operative deaths were 26 times and 3 cases respectively in the early period group, while 13 times and 0 in the late period group. Conclusions The new technique of venovenous bypass prior to mobilization of liver in OLTx could significantly decrease the intraoperative blood loss, but not prolong venevenous bypass time and nonhepatic period time. This technique is helpful in improving postoperative clinical course and lessening the postoperative complications in the patients of OLTx. Partcularly it is fits for patients with terminal liver cirrhosis and liver carcinoma who undergoing OLTx.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2002年第4期200-201,共2页
Chinese Journal of Organ Transplantation
关键词
原位肝移植术
体外静脉转流
外科手术
Liver transplantation
Liver cirrhosis
Arteriovenous shunt, surgical
