原位肝脏移植一例麻醉处理

Anesthesia Management of Orthotopic Liver Transplantation

1994年5月10日我院在动物实验的基础上,成功地完成了1例同种原位肝脏移植术,受者为晚期肝硬化合并门静脉高压症患者。采用无肝期体外静脉转流术,即采用进口离心式生物泵进行无肝期门静脉、右股静脉向左腋静脉的转流。此方法在很大程度上防止阻断门静脉及下腔静脉后循环的非生理状态,而对血流动力学和肾功能影响甚微。术后无手术并发症发生,增加了围手术期的安全性,术后病人存活至今。现将手术期麻醉的监测、处理等作一简介。

An orthotopic liver transplantation was successfully performed on an end-stage hepatitis B-related cirrhotic patient with portal hypertension. The recipient's operation was performed under the venove-nous bypass during the anhepatic phase. A pump-drived veno-venous bypass was built from portal vein and the right femoral vein to the left axillary vein. This method largely minimized the pathophysiologic changes during the anhepatic phase. The effect on hymodynamics and renal function was slight. No surgical complication was observed after the transplantation. The patient is surviving up to time qf reporting.