【摘要】 目的 :探讨肝移植治疗乙型肝炎肝硬化的手术时机和不同术式原位肝移植 [标准原位肝移植(SOLT)、背驮式原位肝移植 (POLT)和改良背驮式原位肝移植 (MPOLT) ]的治疗效果。方法 :分析 5例乙型肝炎肝硬化病人接受 6次肝移植手术 (每种术式各 2次 ,包括 1例再次背驮式原位肝移植和 1例肝肾联合移植 )的病例资料。结果 :5例中 3例已分别存活 19个月、5个月和 5个月。 1例因门静脉血栓复发再次行背驮式肝移植 ,于再次术后第 7天死于多器官功能衰竭 ;另 1例于术后第 6 7天死于严重的肺部感染。术中各术式出血量分别为 35 0 0ml(SOLT)、4 2 5 0ml(POLT)和 10 0 0ml(MPOLT)。结论 :乙型肝炎肝硬化终末期患者是肝移植适应证。相对于SOLT和POLT ,MPOLT术式具有出血少、手术时间短的优点更多还原

【Abstract】 Objective:To investigate the timming of liver transplantation and the effect of different operation styles of OLT(standard orthotopic liver transplantation,SOLT;piggyback orthotopic liver transplantation,POLT;modified piggyback orthotopic liver transplantation,MPOLT) for hepatitis B cirrhosis.Methods:From Mar.2001 to May 2002,5 patients with hepatitis B cirrhosis underwent 6 operations of OLT(each style of OLT for two operations,including 1 case of piggyback retransplatation and 1 case combined liver kidney transplatation).Results:Three of 5 patients have survived for 19,5 and 5 months,respectively after operation. One patient died of MOF at the 7th post reoperative day after re transplantation owing to potal vein thrombosis and another one died of severe pulmonary infection at the 67th post operative day. The amount of bleeding during OLT operation is 3500 ml with SOLT,4250 ml with POLT and 1000 ml with MPOLT.Conclusion:End stage hepatitis B cirrhosis is an indication for OLT. The operation style of MPOLT shows several advantages including less bleeding,shorter operation time as compared with SOLT and POLT.更多还原