论文部分内容阅读
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。
Objective To investigate the efficacy of orthotopic liver transplantation in the treatment of hepatitis B-related diseases and the role of L amivudine in the prevention and treatment of hepatitis B recurrence after liver transplantation. Methods Ten patients underwent orthotopic liver transplantation. Nine of them were hepatitis B patients, and one of them was a liver cancer patient without hepatitis B infection before operation. 9 cases of hepatitis B patients in 6 cases and have varying degrees of hepatic encephalopathy, 1 case of hepatorenal syndrome, 1 case of upper gastrointestinal bleeding. Seven out of nine hepatitis B patients took L amivudine to prevent postoperative hepatitis B recurrence. Results Eight patients survived from February to December and two died. Of the 8 surviving patients, 7 were hepatitis B patients. Only 1 patient showed HBsAg (+) at 9 months after operation, but all had good liver function. The other 1 patient was liver cancer with hepatitis B at 6 months after operation. One of the two deaths was due to recurrent hepatitis B after fulminant hepatic failure, and the other one died of postoperative multiple organ failure. Conclusion orthotopic liver transplantation is an effective method for the treatment of hepatitis B. L amivudine can prevent the recurrence of hepatitis B after hepatitis B transplantation during the observation period.