摘要
目的 探讨原位肝移植术(OLT)后肝脓肿的病因、诊断、治疗和预防措施。方法 自1993年1月至2003年6月,本中心共行OLT 274例,术后并发肝脏肿6例(2.2％)。患者主要临床表现有发热、寒战、腹痛、身目黄染、肝功能损害、低蛋白血症、贫血、白细胞及中性粒细胞比例增高等。诊断主要根据临床表现及超声或CT检查。治疗方法主要包括脓肿抽吸引流、清除阻泥、抗炎和支持治疗。结果 6例中2例治愈,3例放弃再次肝移植术,2例死于严重全身感染,治愈率为33.3％。结论 OLT后肝脓肿病因较复杂,可能与肝动脉血栓或狭窄、甲基强的松龙冲击治疗、胆管炎症和介入治疗等有关。OLT后肝脓肿的预后较差,应加强预防措施防止其发生。
Objective To investigate etiology,diagnosis,treatment and prophylaxis of liver abscess after
orthotopic liver transplantation (OLT). Methods Of 274 recipients of OLT from January 1993 to June 2003 in our
transplant center, liver abscess were identified in 6 recipients (2.2%). The clinical presentation included fever, shiver,
abdominal pain, jaundice, hepatic dysfunction, hypoalbuminemia, anemia, leukocytosis and neutrophilia. They were
diagnosed mainly according to the clinical presentation and Ultrasonography or CT scan. The treatments included
aspiration and drainage of abscess, removing bile sludge, antibiotics and supportive therapy. Results Of 6 patients, 2
were cured, 3 refused liver retransplantation and 2 died of serious systemic infection. The cure rate was 33.3%. Conclu-
sions the etiology of liver abscess after OLT is complicated. The predisposing factors might be included hepatic artery
thrombosis or stenosis, MP pulse therapy, cholangitis and biliary interventional therapy. Its prognosis seemed disappoiting.
Strong prophylactic measures should be recommended to reduce the liver abscess after OLT.
出处
《中华肝脏病杂志》
CAS
CSCD
2004年第6期335-337,共3页
Chinese Journal of Hepatology
基金
卫生部临床学科重点项目(2001321)
广东省医学联台攻关项目(2002B30207)
广东省科委攻关项目(99B06705G)
广州市科委基金(2001-2-043-01-1)
