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肝移植术中脾肾分流的个体化处理

程道柔 杨卿 张英才 王励 谌小龙 李慧 杨扬 陈规划 汪根树

程道柔, 杨卿, 张英才, 等. 肝移植术中脾肾分流的个体化处理[J]. 器官移植, 2019, 10(4): 443-448. doi: 10.3969/j.issn.1674-7445.2019.04.016
引用本文: 程道柔, 杨卿, 张英才, 等. 肝移植术中脾肾分流的个体化处理[J]. 器官移植, 2019, 10(4): 443-448. doi: 10.3969/j.issn.1674-7445.2019.04.016
Cheng Daorou, Yang Qing, Zhang Yingcai, et al. Individualized treatment of splenorenal shunt during liver transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(4): 443-448. doi: 10.3969/j.issn.1674-7445.2019.04.016
Citation: Cheng Daorou, Yang Qing, Zhang Yingcai, et al. Individualized treatment of splenorenal shunt during liver transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(4): 443-448. doi: 10.3969/j.issn.1674-7445.2019.04.016

肝移植术中脾肾分流的个体化处理

doi: 10.3969/j.issn.1674-7445.2019.04.016
基金项目: 

广东省科技计划项目 2017B020209004

详细信息
    作者简介:

    程道柔,男,1991年生,硕士研究生,研究方向为肝移植与急性肝损伤,Email:cdr_atiesh@163.com

    通讯作者:

    汪根树,男,1968年生,博士,主任医师,研究方向为肝癌的临床与基础研究,Email:wgsh168@163.com

  • 中图分类号: R617

Individualized treatment of splenorenal shunt during liver transplantation

More Information
  • 摘要:   目的  评估肝移植术中个体化处理脾肾分流的安全性和有效性。  方法  回顾性分析2例行原位肝移植并术中处理脾肾分离的受者临床资料,根据脾肾分流和供肝复流后灌注情况,2例受者术中分别行左肾静脉结扎术和脾肾分流血管结扎术。观察受者的术后一般情况,包括手术相关并发症、门静脉血流峰值速度、肝功能和肾功能指标。通过腹部超声监测受者术后情况。  结果  2例受者术中及术后均未出现手术相关并发症。病例1和病例2脾肾分流前后门静脉血流峰值速度的变化分别为22.9~35.1 cm/s、24.3~58.8 cm/s。2例受者术后丙氨酸转氨酶(ALT)未出现延迟恢复。病例1受者术后出现一过性血清肌酐(Scr)升高,于术后13 d恢复正常。术后随访过程中,超声检查显示门静脉血流方向和速度正常,肝脏灌注良好。  结论  肝移植术中对合并严重脾肾分流的受者选择性结扎其左肾静脉或脾肾分流血管是安全和有效的。

     

  • 图  1  病例1游离及结扎左肾静脉的手术过程

    A图示术中游离左肾静脉;B图示术中结扎左肾静脉;C图示左肾静脉结扎前;D图示左肾静脉结扎后

    Figure  1.  The surgical procedure of dissociation and ligation of the left renal vein in case 1

    图  2  病例2游离脾肾分流血管的手术过程

    Figure  2.  The surgical procedure of dissociation of the splenorenal shunt vessel in case 2

    图  3  肝移植术后受者腹部超声检查结果

    A图示病例1受者术后1 d超声检查结果;B图示病例1受者术后6个月超声检查结果;C图示病例2受者术后1 d超声检查结果;D图示病例2受者术后7个月超声检查结果

    Figure  3.  Results of abdominal ultrasonography of recipients after liver transplantation

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出版历程
  • 收稿日期:  2019-05-17
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2019-07-15

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