高原肝泡状棘球蚴病自体肝移植术后并发症的分析

高超; 叶成杰; 郭亚民; 吴纲

doi:10.3969/j.issn.1674-7445.2016.06.007

高原肝泡状棘球蚴病自体肝移植术后并发症的分析

Analysis of postoperative complications after autologous liver transplantation in hepatic alveolar echinococcosis patients from plateau area

摘要

摘要:
目的分析高原肝泡状棘球蚴病(HAE)自体肝移植术后常见的并发症。
方法回顾性分析6例行离体或半离体病肝切除+自体肝移植术的晚期HAE患者的临床资料。分析其主要术后并发症的特点。
结果 HAE肝移植术后并发症主要包括胆道并发症(4例)、腹腔出血(1例)、感染(3例)，其中2例患者发生胆漏并腹腔感染，因感染性休克、多脏器功能衰竭死亡；1例患者出现腹腔出血，因失血性休克、弥散性血管内凝血死亡。胆道并发症和腹腔出血是导致患者死亡的主要原因。
结论胆道并发症、腹腔出血、感染等术后并发症是影响HAE自体肝移植术患者预后的主要因素。

Abstract:
Objective To analyze common postoperative complications after autologous liver transplantation in patients diagnosed with hepatic alveolar echinococcosis (HAE) from plateau area.
Methods Clinical data of 6 patients with advanced HAE undergoing ex-situ or partially ex-situ hepatectomy combined with autologous liver transplantation were retrospectively analyzed. Clinical characteristics of postoperative complications were analyzed.
Results Postoperative complications mainly included biliary tract complications (n=4), intra-abdominal hemorrhage (n=1), infection (n=3). Two cases presented with bile leakage complicated with intra-abdominal infection and died from infectious shock and multiple organ dysfunction syndrome. One patient had intra-abdominal hemorrhage and died from hemorrhagic shock and disseminated inravascular coagulation. Biliary tract complication and intra-abdominal hemorrhage were primary causes of mortality.
Conclusions Biliary tract complication, intra-abdominal hemorrhage and infection are the main prognostic factors for HAE patients undergoing autologous liver transplantation.

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