器官移植
器官移植
기관이식
OGRAN TRANSPLANTATION
2014年
4期
213-216
,共4页
李大伟%陆天飞%华相伟%夏强%张建军%李齐根%徐宁%陈小松%张明%韩龙志%奚志峰
李大偉%陸天飛%華相偉%夏彊%張建軍%李齊根%徐寧%陳小鬆%張明%韓龍誌%奚誌峰
리대위%륙천비%화상위%하강%장건군%리제근%서저%진소송%장명%한룡지%해지봉
儿童终末期肝病模型%婴幼儿%活体肝移植%预后
兒童終末期肝病模型%嬰幼兒%活體肝移植%預後
인동종말기간병모형%영유인%활체간이식%예후
Pediatric end-stage liver disease%Infant%Living donor liver transplantation%Prognosis
目的：探讨儿童终末期肝病模型（PELD）评分系统用于预测婴幼儿活体肝移植预后的作用。方法回顾性分析2006年10月至2012年12月上海交通大学医学院附属仁济医院肝脏外科收治的101例小儿活体肝移植临床资料。患儿术前诊断均为胆道闭锁。术前对每例患儿进行PELD 评分，根据PELD评分将患儿分为两组：低分组（PELD评分＜16分，62例）和高分组（PELD评分≥16分，39例）。比较两组患儿围手术期的基本情况及术后并发症发生率。结果两组患儿的手术年龄和体重差异均有统计学意义（均为P＜0.05），但两组性别、移植物（肝）重量/受体的体重、供肝冷缺血时间、术中失血量等差异均无统计学意义（均为P＞0.05）。PELD高分组患儿移植术后的肺部感染和胆道并发症发生率均明显高于低分组（均为P＜0.05）。结论术前PELD评分可用于预测婴幼儿肝移植的预后，为婴幼儿肝移植的围手术期的治疗、监护及护理措施的制定提供参考。对于术前PELD评分较高的患儿，应加强围手术期并发症的监护处理。
目的：探討兒童終末期肝病模型（PELD）評分繫統用于預測嬰幼兒活體肝移植預後的作用。方法迴顧性分析2006年10月至2012年12月上海交通大學醫學院附屬仁濟醫院肝髒外科收治的101例小兒活體肝移植臨床資料。患兒術前診斷均為膽道閉鎖。術前對每例患兒進行PELD 評分，根據PELD評分將患兒分為兩組：低分組（PELD評分＜16分，62例）和高分組（PELD評分≥16分，39例）。比較兩組患兒圍手術期的基本情況及術後併髮癥髮生率。結果兩組患兒的手術年齡和體重差異均有統計學意義（均為P＜0.05），但兩組性彆、移植物（肝）重量/受體的體重、供肝冷缺血時間、術中失血量等差異均無統計學意義（均為P＞0.05）。PELD高分組患兒移植術後的肺部感染和膽道併髮癥髮生率均明顯高于低分組（均為P＜0.05）。結論術前PELD評分可用于預測嬰幼兒肝移植的預後，為嬰幼兒肝移植的圍手術期的治療、鑑護及護理措施的製定提供參攷。對于術前PELD評分較高的患兒，應加彊圍手術期併髮癥的鑑護處理。
목적：탐토인동종말기간병모형（PELD）평분계통용우예측영유인활체간이식예후적작용。방법회고성분석2006년10월지2012년12월상해교통대학의학원부속인제의원간장외과수치적101례소인활체간이식림상자료。환인술전진단균위담도폐쇄。술전대매례환인진행PELD 평분，근거PELD평분장환인분위량조：저분조（PELD평분＜16분，62례）화고분조（PELD평분≥16분，39례）。비교량조환인위수술기적기본정황급술후병발증발생솔。결과량조환인적수술년령화체중차이균유통계학의의（균위P＜0.05），단량조성별、이식물（간）중량/수체적체중、공간랭결혈시간、술중실혈량등차이균무통계학의의（균위P＞0.05）。PELD고분조환인이식술후적폐부감염화담도병발증발생솔균명현고우저분조（균위P＜0.05）。결론술전PELD평분가용우예측영유인간이식적예후，위영유인간이식적위수술기적치료、감호급호리조시적제정제공삼고。대우술전PELD평분교고적환인，응가강위수술기병발증적감호처리。
Objective To explore the value of pediatric end-stage liver disease (PELD)score system in predicting prognosis after pediatric living donor liver transplantation (LDLT). Methods Clinical data of 101 infants undergoing living-donor liver transplantation from October 2006 to December 2012 in Department of Liver Surgery in Affiliated Renji Hospital of School of Medicine of Shanghai Jiaotong University,were analyzed retrospectively. All infants were diagnosed as biliary atresia. PELD scores before LDLT were graded. According to PELD scores,all the patients were divided into two groups:low score group (PELD score <16,n=62) and high score group (PELD≥16,n =39 ).The basic data during perioperative period and incidence of postoperative complications were compared between two groups. Results There were significant differences in age and body weight between two groups (both in P<0.05 ). But there was no significant difference between the two groups in gender,graft to recipient weight ratio (GRWR),cold isehemia time and intraoperative blood loss (all in P>0.05 ). The incidence of lung infection and biliary complications in high score group were significantly higher than those in low score group. Conclusions Preoperative PELD score can be used in predicting prognosis after pediatric LDLT and provide a reference for the treatment,caring and nursing during perioperative period of pediatric LDLT. For infants with high PELD score before operation,the care of perioperative complications should be enhanced.
