摘要
目的探讨肝移植对于原发性硬化性胆管炎(PSC)的诊治效果。方法采用回顾性研究方法,选取2013年7月至2019年7月首都医科大学附属北京友谊医院收治的接受肝移植的15例PSC患者,其中男性8例,女性7例;平均年龄(46.0±13.0)岁。分析其一般情况、移植等待时间、并发症发生率、疾病复发率、生存期等。结果15例PSC患者中,平均诊断年龄36.3±8.2(22.8~47.6)岁;移植等待时间为0.2~2.0年,平均1.1±0.6年。1例患者合并胆管癌。随访最长74个月,4例(26.7%)患者出现移植术后并发症,其中2例患者出现排异伴感染性疾病,2例患者出现胆道并发症。2例(13.3%)患者出现PSC复发,时间分别为31和74个月。无病生存期及总生存期分别为(37.3±18.9)个月,(38.1±21.3)个月。结论目前肝移植仍是PSC唯一有效的治疗方式。从术后并发症发生率和生存时间等方面评价,肝移植治疗PSC总体预后良好,但同时也伴随着疾复发、胆道并发症、排异反应等影响预后的危险因素,有针对性地进行密切随访可使患者获得更满意的远期预后。
Objective To evaluate the therapeutic effect of liver transplantation on primary sclerosing cholangitis(PSC).Methods All the 15 adult patients(age>18 years),including 8 males and 7 females with a mean age of 46.0±13.0 years old,who received liver transplantation due to PSC from July 2013 to July 2019 were enrolled in this study.The general situation,clinical indicators,time to LT,incidence of complications,survival time and recurrence rate were analyzed retrospectively.Results The mean age at diagnosis was 36.3±8.2 years(22.8~47.6 years).Median time to transplantation was 1.1±0.6 years(0.2~2.0 years).Cholangiocarcinoma was diagnosed in 1 patient(6.5%).The follow-up period was up to 74 months and postoperative complications were observed in 4 patients(26.7%),including rejection of infectious diseases in 2(13.3%)patients and biliary tract complications in 2(13.3%)patients.PSC recurred at 31 and 74 months after LT in 2 patients(13.3%),respectively.Disease-free survival and overall survival were 37.3±18.9 months and 38.1±21.3 months,respectively.Conclusion Liver transplantation is still the only effective treatment method for PSC.LT in these patients can receive favorable outcomes regarding postoperative morbidity and mortality compared with other etiologies,but it is also accompanied by disease recurrence,biliary tract complications,rejection reaction and other risk factors.Satisfactory long-term outcomes can be reached with close follow-up.
作者
王君
朱志军
曲伟
魏林
孙丽莹
刘颖
檀玉乐
曾志贵
张海明
WANG Jun;ZHU Zhi-Jun;QU Wei(Clinical Center for Liver Transplantation,Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2019年第19期2095-2097,共3页
Journal of Clinical and Experimental Medicine
基金
北京市科学技术委员会"首都临床特色应用研究"资助课题(编号:Z181100001718220)
关键词
原发性硬化性胆管炎
肝移植
胆汁淤积性肝病
排异反应
Primary sclerosing cholangitis
Liver transplantation
Cholestatic liver disease
Rejectio
