合并供肝动脉变异肝移植肝动脉重建42例临床分析

摘要

目的：探讨供肝动脉变异对肝移植术后动脉及胆道并发症的影响，总结肝移植肝动脉重建方式。方法查阅我院2005年5月至2015年4月实施的肝移植手术病例210例，其中，合并供肝动脉变异（动脉变异组）42例，未合并供肝动脉变异（非变异组）168例。对病例进行回顾性分析。结果210例肝移植中，供肝动脉变异42例，变异率20.0%。动脉变异组肝动脉重建后血流均值（174.7±95.1）mL/min，非变异组血流均值（190.9±101.6）mL/min，2组无统计学差异（P=0.519）。共有12例（5.71%）患者发生动脉并发症，其中动脉变异组4例（4/42），非变异组8例（8/168），2者间无统计学差异（χ2=0.72，P>0.05）。共有25例（11.9%）发生了胆道并发症，其中动脉变异组5例（5/42），非变异组20例（20/167），两组无统计学差异（χ2=0.05，P>0.05）。结论供肝动脉变异重建不会增加肝动脉及胆道并发症的发生。%Objective To explore the influence of abnormal donor hepatic artery on hepatic artery and biliary complications after liver transplanta⁃tion,and summarize the hepatic artery reconstruction procedures during transplantation. Methods The clinical data of 210 cases of liver transplan⁃tation conducted in our hospital from May 2005 to April 2015 were retrospectively searched for the study,including 42 with abnormal donor hepatic artery. Results Among the 210 liver transplantation,42 cases exhibited abnormal donor hepatic artery,and the aberration rate was 20.0%. Mean volume of blood flow of abnormal group and normal group was 4.7±95.1 mL/min and 190.9±101.6 mL/min,respectively. There was no statistic differ⁃ence(P=0.519). Twelve cases had arterial complications,the incidence rate was 5.71%,and there was no statistic difference between each group (χ2=0.72,P>0.05). Twenty five cases got biliary complications,the incidence rate was 11.9%,and there was no statistic differences between each group(χ2=0.05,P>0.05). Conclusion There was no statistic difference of mean volume of blood flow after arterial reconstruction between two groups. Liver transplantation with abnormal arterial reconstruction will not increase the incidence rate of arterial and biliary complications.