小儿Wilson’s病亲属活体部分肝移植围术期处理的探讨

Preliminary experience of living related liver transplantation for Wilson’s disease in children

目的 :总结小儿Wilson’s病亲属活体部分肝移植术围术期处理的特殊性。方法 :1例Wilson’s病患儿在全麻下行亲属活体部分原位肝移植 ,术中连续监测体温、血流动力学、血气、生化、凝血功能及血常规。结果 :与术前相比 ,术中血钾、血糖、凝血功能、血红蛋白、心率、体温均有显著变化。结论 :在确保供体安全的同时维持受体的血流动力学稳定 ,随时纠正水电解质和酸碱平衡的紊乱 ,加强血气、生化及凝血功能的监测与调控是手术顺利完成的关键。

Objective To investigate living related part liver transplantation for Wilson's disease in children. Methods One paediatric patient with Wilson's disease undergoing orthotropic living related part liver transplantation was under general anesthesia. Temperature, hemodynamics, blood routine, blood gas, biochemical changes and coagulation were continuously monitored during the operation. Results The perioperative changes of blood potassium, glucose, clotting function, hemoglobin, heart rate and temperature were of significant different compared with the preoperative. Conclusions Besides ensuring the safety of donor, maintaining hemodynamic stability, correcting fluid electrolyte and acid base disorder in time, reinforcing the monitoring and adjustment of blood gas, biochemical alterations and clotting function are the most important for successful operation on recipient.