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肝移植治疗危重症肝病的临床疗效研究

寇建涛 刘喆 朱继巧 马军 许文犁 李瀚 贾亚男 李先亮 贺强

寇建涛, 刘喆, 朱继巧, 等. 肝移植治疗危重症肝病的临床疗效研究[J]. 器官移植, 2020, 11(4): 482-486. doi: 10.3969/j.issn.1674-7445.2020.04.010
引用本文: 寇建涛, 刘喆, 朱继巧, 等. 肝移植治疗危重症肝病的临床疗效研究[J]. 器官移植, 2020, 11(4): 482-486. doi: 10.3969/j.issn.1674-7445.2020.04.010
Kou Jiantao, Liu Zhe, Zhu Jiqiao, et al. esearch on clinical efficacy of liver transplantation for severe liver disease[J]. ORGAN TRANSPLANTATION, 2020, 11(4): 482-486. doi: 10.3969/j.issn.1674-7445.2020.04.010
Citation: Kou Jiantao, Liu Zhe, Zhu Jiqiao, et al. esearch on clinical efficacy of liver transplantation for severe liver disease[J]. ORGAN TRANSPLANTATION, 2020, 11(4): 482-486. doi: 10.3969/j.issn.1674-7445.2020.04.010

肝移植治疗危重症肝病的临床疗效研究

doi: 10.3969/j.issn.1674-7445.2020.04.010
基金项目: 

国家自然科学基金 81571554

国家自然科学基金 81273270

国家自然科学基金 81471590

详细信息
    作者简介:

    寇建涛,男,1973年生,博士,副主任医师,Email: koujt@medmail.com.cn

    通讯作者:

    李先亮,男,1971年生,博士,副主任医师,研究方向为器官移植诱导免疫耐受,Email:lixianliangbjcy@126.com

    贺强,男,1964年生,博士,主任医师,研究方向为器官移植诱导免疫耐受,Email:heqiang349@sina.com

  • 中图分类号: R617, R575.3

esearch on clinical efficacy of liver transplantation for severe liver disease

More Information
  • 摘要:   目的  探讨肝移植手术治疗危重症肝病的临床疗效。  方法  回顾性分析接受肝移植治疗的51例危重症肝病患者的临床资料。观察患者术中的一般情况,包括手术时间、热缺血时间、冷缺血时间、无肝期、出血量、输血量、输血浆量等指标;观察术前及术后3 d、1周及2周患者总胆红素(TB)、凝血酶原活动度(PTA)、凝血酶原时间国际标准化比值(PT-INR)等指标的变化情况;分析受者的术后生存情况及并发症发生情况;对可能影响危重症肝病患者预后的指标进行Cox回归分析。  结果  51例患者的手术时间为8(7, 9)h,供肝热缺血时间为3(2, 3)min,冷缺血时间为6(5, 8)h,术中无肝期为80(70, 100)min,术中出血量为1 000(550, 1 500)mL,术中输血量为1 200(200,1 600)mL。术后TB、PTA、PT-INR等指标较术前明显改善。51例患者中,10例死亡,死亡原因分别为多器官功能衰竭及严重感染7例、肾功能不全2例、心血管并发症1例。危重症肝病患者移植术后1个月和1年的生存率分别为82%和80%。Cox回归分析提示术前PTA、PT-INR异常是危重症肝病患者肝移植术后死亡的危险因素。  结论  肝移植能够显著提高危重症肝病患者的生存率,加强围手术期感染的防治和多器官功能管理是提高危重症肝病患者移植术后生存率的关键措施。

     

  • 图  1  危重症肝病患者肝移植手术前后相关指标的变化

    注:与术前比较,aP < 0.001。

    Figure  1.  Changes of relevant indexes before and after liver transplantation in patients with severe liver disease

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出版历程
  • 收稿日期:  2020-04-19
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-07-15

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