【摘要】 目的　探讨原位肝移植治疗乙型肝炎相关疾病的效果及 L amivudine在防治肝移植后乙肝复发中的作用。方法　 10例患者接受了原位肝移植 ,其中 9例男性为乙肝患者 ,1例女性为肝癌患者 ,术前无乙肝感染。 9例乙肝患者 6例并有不同程度的肝性脑病 ,1例并肝肾综合征 ,1例并上消化道大出血。 9例乙肝中 7例服用 L amivudine预防术后乙肝复发。结果　 8例存活 2月～ 12月 ,2例死亡。存活的 8例中 7例为乙肝患者 ,仅 1例术后 9个月出现 HBs Ag(+) ,但全部均肝功能良好 ;另 1例为肝癌患者 ,术后 6个月出现乙肝。死亡的 2例中 1例为术后乙肝复发暴发性肝功能衰竭所致 ,另 1例死于术后多器官功能衰竭。结论　原位肝移植是治疗乙肝的有效方法 ,L amivudine在观察期内可预防乙肝移植后乙肝复发。更多还原

【Abstract】 Objectives To investigate the effect of orthotopic liver transplantation(OLT) on hepatits B associated diseases and the efficiency of prevention and treatment with Lamivudine on the recurrence of hepatits B.Methods Ten patients received orthotopic liver transplantation.9 males had hepatitis B and 1 female had preoperatively hepaticcellular cancer (HCC) without hepatits B pretransplantation.Six of nine patients with hepatitis B had hepatic encephatopathy,1 with hepatorenal syndrome and one with upper gastroenteric bleeding.Seven patients were treated with Lamivudine to prevent the recurrence of hepatits B.Results Eight patients survived 2～12 mouths,but 2 died seperatively of multiorgan failure or fulminat hepatitis B recurrunce.Seven of 8 survivors with hepatits B pretransplantation have excellent liver function though 1 with positive HBsAg 6 months after OLT.One of eight survivors,the female with HCC pretansplantation suffered hepatitis B 6 months after OLT.Conclusion OLT is an effective therapy for hepatitis B and Lamivudine may prevent recurrence of hepatitis B after OLT during our observation.更多还原