| 罗文峰 时军 徐志丹 李新长 龙成美.肝移植术后近期黄疸的病因分析与治疗[J].实用中西医结合临床,2007,(6):8-9 |
| 肝移植术后近期黄疸的病因分析与治疗 |
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| DOI： |
| 中文关键词: 肝移植 黄疸 病因 治疗 |
| 英文关键词: Liver transplantation Jaundice Etiology Treatment |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨肝移植术后近期黄疸的病因与处理。方法：采用临床生化、肝穿剌活检等方法，回顾性分析我院实施的25例肝移植的临床资料，分析总结肝移植术后近期黄疸的原因，并提出相应的防治措施。结果： 25例肝移植受者术后1周内血总胆红素均进行性升高，2周左右达高峰，之后逐渐下降，绝大多数4周内恢复至接近正常水平。25例肝移植受者中1例因原发性供肝无功能于术后14d死亡，1例因术后肝癌复发并全身转移于术后5个月死亡，其余受者术后近期黄疸临床均治愈。结论：肝移植术后近期黄疸的主要病因是供肝保存损伤，其次是急性排斥反应、药物性肝损害、感染、原发病复发、手术技术因素及胆道并发症、术前黄疸等原因。对术后近期黄疸首先要进行病因鉴别，而肝穿剌活检是最直接最可靠的诊断手段，针对其病因进行综合治疗，常可取得良好的临床效果。 |
| 英文摘要: |
| Objective:To investigate the etiology and treatment of the early postoperative jaundice after liver transplantation. Methods:Taking clinical biochemistry、liver biopsy etc.Retrospectively analyzed the clinical document of the 25 liver transplants which operated in our hospital, summarized the etiology of the early jaundice after liver transplantation, and put out the according treatment. Results:The total serum bilirubin(TB) level of the 25 liver transplants all raised up in one week, and reached peak level around 2 weeks, then came down slowly, most of the patients’ TB went back close to the normal level with in 4 weeks. One of the 25 liver transplants had been dead of Primary hepatic failure after 14 days of transplantation, another patient had been dead of liver carcinoma’s relapse and dispersion after 5 months of transplantation, all other patients’ early postoperative jaundice was treated well.Conclusion:The main etiology of the early postoperative jaundice is Preservative injury, then comes to acute rejection、liver injury by medicine 、infection、primary disease relapse、operation technology and bile duct leakage、preoperative jaundice etc. The first step of the treatment for the early postoperative jaundice is to differentiate the etiology,while the liver biopsy is the most direct and reliable diagnostic method. The comprehensive treatment targeted to etiology can achieve a good outcome for the recipient with jaundice. |
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