摘要
目的 介绍1例活体肝部分移植术的临床经过及长期管理。方法 受体为10岁女童。供体为患儿40岁的父亲,手术方式为切取供体肝脏的左外侧叶,并原位移植给患儿。术后进行了严格的监护治疗和长期随访。结果 供体手术历时400min,出血410ml,切取肝脏300g,术后顺利恢复。受体手术历时652min,出血1665ml,无肝期80min,移植肝脏热缺血时间为0,冷缺血时间137min。受体术后因供肝断面和剥离面出血2次进腹止血。采用环孢霉素A,硫唑嘌呤及皮质激素行免疫抑制治疗,术后第11d出现急性排斥反应,经激素冲击治疗而愈。术后还出现胸水、腹水、切口裂开、输血反应、口腔粘膜病变、上呼吸道感染、肠梗阻等并发症,都经治而愈。患者已健康生存25年,肝功能正常。结论 精细的手术和良好的围手术期处理是确保肝移植术成功的关键,术后准确细致的长期管理是肝移植术后长期健康生存的必要条件。
Objective To report the clinical course and long term management of a patient with living related liver transplantation. Abstract: Objective To report the clinical course and long term management of a patient with living related liver transplantation. Methods The recipient was a 10 year old girl. The donor was the patient's father aged 40 years. The left lateral lobe of donor's liver was cut and grafted to the recipient orthotopicallg. Intensive care and treatment as well as long term follow up were made after operation. Results For the donor, the operation lasted 400?min with bleeding of 410?ml and 300?g liver removed. The donor recovered successfully. For the recipient, the operation lasted 652?min with bleeding of 1?665?ml. The non liver period lasted 80?min, warm ischemic period was not happened and cold ischemic period of graft was 137?min. Intra abdomial hemostasis was performed twice due to bleeding on the liver incision surface. Cyclosporin A, azathioprine and prednisone were given as immunosupressive therapy. An acute rejection occurred on the eleventh day after operation, which was controlled by hormone impact therapy. Other complications such as hydrothorax, ascites and intestinal obstruction etc were cured. The patient has been surviving 2.5 years with normal liver function. Conclusions Careful operation and perioperative care are important for successful liver transplantation. Optimal long term postoperation management is impotant for patient with liver transplantation to keep long term healthy survival.
出处
《中国普通外科杂志》
CAS
CSCD
2000年第1期64-67,共4页
China Journal of General Surgery
关键词
肝移植
存活率
随访研究
LIVER TRANSPLANTATION
SURVIVAL RATE
FOLLOW-UP STUDIES
