肝移植治疗重症肝炎的临床分析

Clinical analysis of liver transplantation as a treatment for severe hepatitis

目的评估重症肝炎患者行肝移植手术的安全性和疗效。方法收集2015年1月1日-2015年12月31日在中南大学湘雅二医院行原位肝移植的患者资料进行统计学分析。结果与非重症肝炎组相比,重症肝炎组术前终末期肝病模型(MELD)评分更高[30.9(27.5,34.7)比17.0(15.0,18.9)],两组患者手术时间、术中无肝期时间、术后感染率、乙肝复发率及1年生存率差异无统计学意义(均P>0.05),但与非重症肝炎组相比,重症肝炎组术中输血量大[术中输血量(ml):3 069.1±1 139.7比699.0±422.7],住院时间更长[37(33,44)比30(28,33)]。结论重症肝炎患者行肝移植手术是安全可靠的,肝移植是重症肝炎的有效治疗手段。

Objective To evaluate the security and efficacy of liver transplantation for severe hepatitis. Methods Medical records of liver transplantations conducted between Jan 1st,2015 and Dec 31 st,2015 were collected and analyzed statistically. Results Before liver transplantation, the model for end-stage liver disease（MELD） score was higher in severe hepatitis group than that in non-severe hepatitis group [30.9（27.5,34.7）] vs.[17.0（15.0,18.9）]. There was no significant difference in operation time,anhepatic phase,infection rate after transplantation, recurrence rate of hepatitis B or 1-year survival rate between groups. But the volume of blood transfusion during operation in severe hepatitis group was higher than that in non-severe hepatitis group（3 069.1±1 139.7 vs. 699.0±422.7）. Patients with severe hepatitis had longer postoperative hospitalization [37（33,44） vs. 30（28,33）]. Conclusion Liver transplantation is safe for patients with severe hepatitis, and it is an effective treatment for severe hepatitis.