中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2010年
7期
496-499
,共4页
邹卫龙%陈新国%臧运金%沈中阳
鄒衛龍%陳新國%臧運金%瀋中暘
추위룡%진신국%장운금%침중양
肝移植%门静脉血栓形成%血管重建%门静脉血流量
肝移植%門靜脈血栓形成%血管重建%門靜脈血流量
간이식%문정맥혈전형성%혈관중건%문정맥혈류량
Liver transplantation%Portal vein thrombosis%Vascular reconstruction%Por-tal vein flow
目的 探讨术前合并门静脉血栓(PVT)对原位肝移植(OLT)受者手术和术后相关参数的影响.方法 回顾性分析2002年2月至2007年2月武警总医院836例成人OLT病人中71例术前合并门静脉血栓(PVT组)和765例无门静脉血栓(对照组)病人的临床资料.比较两组手术时间、无肝期时间、输血量等手术参数以及ICU时间、住院时间、PVT复发、移植物功能、门静脉血流量、围手术期病死率和1、3、5年生存率等术后参数.结果 PVT组手术时间(min)和无肝期时间(min)明显长于对照组(分别为792.47±162.29和516.18±186.30,P<0.01;77.53±24.76和48.55±31.20;P<0.05).两组间术中输血量、平均ICU时间、住院时间没有显著差异(P>0.05).PVT组术后再栓塞率显著高于对照组(分别为9.86%和1.44%,P<0.01).除90 d时PVT组门静脉血流(PVF,cm/s)较高(41.43±17.19和19.85±11.39,P<0.05)外,两组间各随访时段移植物功能和PVF没有显著性差异.PVT组围手术期病死率略高于对照组而1、3、5年生存率稍低于对照组,但是差异均没有显著性.结论 术前PVT可能会增加肝移植手术复杂程度,但并不影响肝移植效果.
目的 探討術前閤併門靜脈血栓(PVT)對原位肝移植(OLT)受者手術和術後相關參數的影響.方法 迴顧性分析2002年2月至2007年2月武警總醫院836例成人OLT病人中71例術前閤併門靜脈血栓(PVT組)和765例無門靜脈血栓(對照組)病人的臨床資料.比較兩組手術時間、無肝期時間、輸血量等手術參數以及ICU時間、住院時間、PVT複髮、移植物功能、門靜脈血流量、圍手術期病死率和1、3、5年生存率等術後參數.結果 PVT組手術時間(min)和無肝期時間(min)明顯長于對照組(分彆為792.47±162.29和516.18±186.30,P<0.01;77.53±24.76和48.55±31.20;P<0.05).兩組間術中輸血量、平均ICU時間、住院時間沒有顯著差異(P>0.05).PVT組術後再栓塞率顯著高于對照組(分彆為9.86%和1.44%,P<0.01).除90 d時PVT組門靜脈血流(PVF,cm/s)較高(41.43±17.19和19.85±11.39,P<0.05)外,兩組間各隨訪時段移植物功能和PVF沒有顯著性差異.PVT組圍手術期病死率略高于對照組而1、3、5年生存率稍低于對照組,但是差異均沒有顯著性.結論 術前PVT可能會增加肝移植手術複雜程度,但併不影響肝移植效果.
목적 탐토술전합병문정맥혈전(PVT)대원위간이식(OLT)수자수술화술후상관삼수적영향.방법 회고성분석2002년2월지2007년2월무경총의원836례성인OLT병인중71례술전합병문정맥혈전(PVT조)화765례무문정맥혈전(대조조)병인적림상자료.비교량조수술시간、무간기시간、수혈량등수술삼수이급ICU시간、주원시간、PVT복발、이식물공능、문정맥혈류량、위수술기병사솔화1、3、5년생존솔등술후삼수.결과 PVT조수술시간(min)화무간기시간(min)명현장우대조조(분별위792.47±162.29화516.18±186.30,P<0.01;77.53±24.76화48.55±31.20;P<0.05).량조간술중수혈량、평균ICU시간、주원시간몰유현저차이(P>0.05).PVT조술후재전새솔현저고우대조조(분별위9.86%화1.44%,P<0.01).제90 d시PVT조문정맥혈류(PVF,cm/s)교고(41.43±17.19화19.85±11.39,P<0.05)외,량조간각수방시단이식물공능화PVF몰유현저성차이.PVT조위수술기병사솔략고우대조조이1、3、5년생존솔초저우대조조,단시차이균몰유현저성.결론 술전PVT가능회증가간이식수술복잡정도,단병불영향간이식효과.
Objective To investigate the impacts of preoperative portal vein thrombosis (PVT) on intraoperative or postoperative parameters in patients receiving orthotopic liver transplantation (OLT). Methods The clinical data of 836 patients undergoing OLT in our hospital from February 2002 to February 2007 were retrospectively analyzed. Of the 836 patients, 71 had preoperative PVT (PVT group) and the other 765 had not (control group). Intraoperative patameters (operative dura-tion, anhepatic phase duration, blood transfusion volume) and postoperative parameters (ICU stay and hospitalization time, portal rethrombosis posttransplantation, graft function, portal vein flow, death rate in perioperation and 1-, 3-, 5-year survival rate) were compared between the 2 groups. Results The operative duration and anheptic phase duration were significantly higher in the PVT group than in the control (792. 47±62. 29 min vs 516. 18±86. 30 min, P<0. 01, 77. 53±24. 76 min vs 48. 55±31. 20 min, P<0. 05). Perioperative blood transfusion volume, average ICU stay and hospitalization duration were not significantly different between the 2 groups. The incidence of postoperative portal rethrombosis was remarkably higher in PVT group than in the control (9. 86% vs 1. 44% , P<0. 01).No significant differences in the graft function and portal vein flow (PVF) between the 2 groups except for a higher PVF in the PVT group on the 90th d(41. 43±17. 19 vs 19. 85±11. 39, P<0. 05). We noticed slightly higher death rate in perioperative and lower 1-, 3-, 5-year survival rate in the PVT group. Conclusion Preoperative PVT can gain the same favorable outcomes as in those without PVT in spite of readily intraoperative complex.
