肝移植治疗乙型肝炎、肝硬化并发肝癌的分析

Treatment of hepatitis B, liver cirrhosis complicated by liver carcinoma： liver transplantation

目的 研究乙型肝炎、肝硬化并发肝癌行肝移植手术时机的选择及术后免疫抑制剂的应用.方法 对9例患者施行肝移植,其中4例为经典式原位肝移植,5例为背驮式原位肝移植,术后应用免疫抑制剂甲基泼尼松龙、他克莫司及吗替麦考酚酯（商品名：骁悉）,同时采用抗乙型肝炎免疫球蛋白及拉米夫定预防乙肝病毒复发.结果 9例肝癌肝移植手术均获成功,2例术前情况差的患者术后死于多器官衰竭,1例死于急性排斥反应,余6例全部生存至今.结论 乙型肝炎、肝硬化并发肝癌最有效的治疗方法之一是肝移植,手术在肝癌转移前进行疗效较好,术后应用免疫抑制剂甲基泼尼松龙、他克莫司及吗替麦考酚酯可以有效控制免疫排斥的发生.

Objective To summarize the clinical experiences of liver transplantation.Methods Of the nine patients, four operation was standard orthotopic liver transplantation,the latter five were the piggyback liver transplantation.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti. Meanwhile intravenous antihepatitis B immunoglobulin and Lamivudine were used to prevent hepatitis B recurrence.Results All patients were cured.Conclusion Liver transplantation can be employed for liver disease both cirrhosis and carcinoma as a conventional surgery.It is an effective way for the treatment of no metastatic liver carcinoma.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti,it can prevent immune rejection.