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目的回顾性分析我院2002年10月~2005年10月6例婴幼儿亲体部分肝移植临床疗效。方法婴幼儿亲体部分肝移植6例,年龄9个月~3岁,男3例,女3例;手术时体重为7~16kg。胆道闭锁Kasai术后肝硬化腹水4例,先天性肝内胆汁淤积症、肝硬化腹水1例,药物性肝炎1例。随访时间为6~36个月。结果供肝提供者分别为母2例,父4例,提供左外叶肝,平均住院7d,无并发症。5例生存,最长36个月。1例因凝血功能障碍,术后24h肾功能衰竭、肺出血死亡。术后免疫治疗药物包括甲基强的松龙、FK506和赛尼派。术后并发症为2例胆瘘,术后出血、再次进腹止血1例,肺部感染1例。结论婴儿期进行部分活体肝移植,扩大了供体来源,临床疗效较好,是婴儿终末期肝病有效的治疗方法。
Objective To retrospectively analyze the clinical effects of 6 cases of infant liver transplantation in our hospital from October 2002 to October 2005. Methods Six infant and parturient liver transplants were performed, ranging in age from 9 months to 3 years. There were 3 males and 3 females with a body weight of 7-16 kg at the time of surgery. Biliary atresia Kasai cirrhosis in 4 cases of ascites, congenital intrahepatic cholestasis, cirrhosis, 1 case of ascites, drug-induced hepatitis in 1 case. Follow-up time was 6 to 36 months. Results The donor liver donors were 2 males and 4 females, respectively. They provided left external lobe liver with an average hospitalization of 7 days and no complication. Five cases survived up to 36 months. 1 case of coagulation disorders, 24h after renal failure, pulmonary hemorrhage died. Postoperative immunotherapeutic drugs include methylprednisolone, FK506 and saeni pie. Postoperative complications were 2 cases of biliary fistula, postoperative bleeding, again into the abdomen to stop bleeding in 1 case, 1 case of pulmonary infection. Conclusion Partial living donor liver transplantation in infancy has expanded the source of donors and has good clinical efficacy. It is an effective treatment for end-stage liver disease in infants.