摘要
目的探讨原位肝移植术后高胆红素血症的原因和治疗手段。方法对2004年1月2005年12月中山大学附属第一医院施行的368例同种原位肝移植患者的临床资料进行回顾性分析。结果368例肝移植患者中累计发生高胆红素血症396例次，其发生原因分别为术前高胆红素血症183例（46．2％，183／396），单纯供肝热、冷缺血再灌注损伤46例（11．6％，46／396），急性排斥反应36例次（9．1％，36／396），胆道并发症36例发生高胆红素血症78例次（19．7％，78／396），血管并发症24例（6．1％，24／396），原发病复发23例（5．8％，23／396）和药物毒性反应6例（1．5％，6／396）；均予针对病因为主的综合治疗，并辅以护肝、退黄疸等对症治疗。结论肝移植术后高胆红素血症的病因多样而复杂，临床上应首先明确其病因，及时作出正确诊断，并选择合理的治疗方案，才能使移植患者症状缓解、获得长期生存。
Objective To investigate the causes and treatment of postoperative hyperbilirubinemia after orthotopic liver transplantation. Methods Clinical data of 368 cases of orthotopic liver transplantation patients from the First Affiliated Hospital of Sun Yat-sen University between 2004 and 2005 were analyzed retrospectively. Results Three hundred and sixty-eight patients experienced 396 incidents of hyperbilirubinemia, including 183 incidents of preoperative hyperbilirubinemia （46.2%）, 46 incidents of ischemia-reperfusion injury （11.6%）, 36 incidents of acute rejection （9.1%）, 78 incidents of biliary complications （19.7%）, 24 incidents of blood vessel complications （6.1%）, 23 incidents of recurrence of the primary disease （5.8%） and 6 incidents of tacrolimus （FK506） toxicity （1.5%）. The comprehensive management targeted to the etiology and symptoms were applied to all patients with hyperbilirubinemia. Conclusion Hyperbilirubinemia is a common clinical manifestation after liver transplantation with multiple and complicated causes. The key point for successful treatment is to identify the causes. To reach the aim of treatment and obtain long-term survival of the recipients, it is very important to make a correct diagnosis and give reasonable therapeutic regimens as soon as possible.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2008年第2期117-120,共4页
Chinese Journal of Hepatology
关键词
肝移植
高胆红素血症
手术后并发症
Liver transplantation
Hyperbilirubinemia
Postoperative complication
