胆道闭锁患儿活体肝移植供者的手术安全性分析

摘要

Objective To evaluate the surgical safety of living donors in liver transplantation for children with biliary atresia.Methods The surgery information from 68 living donors in liver transplantation for children with biliary atresia was collected .The operative time and blood loss in the operation was analyzed , and venous blood was collected to test liver function and coagulation function at day 1, 3, 5 and 7 after the operation.At same time, postoperative complications were recorded.Results Median operative time was 312 min (271-875 min) and blood loss in the operation was 100 mL (45-210 mL) .The TB, ALT, AST and international normalized ratio ( INR) on day 1 after operation were higher than those of preoperation (P<0.05).The liver function and blood coagulation parameters were all decreased on day 3 after opera-tion.Seven cases (10.3%) had postoperative complications , including 3 cases of incision steatosis , 2 cases of postopera-tive ascites, 1 case of bleeding in liver sections and 1 case of bile leakage , and all postoperative complications were timely detected and treated .After follow-up of 5 to 34 months, all donors were cured and recovered well and the liver function was good, and no discomfort was found .Conclusion The surgical safety of living donors in liver transplantation for children with biliary atresia is high , postoperative complications are less , and all donors recover well after operation .%目的：探讨胆道闭锁患儿活体肝移植供肝者的手术安全性。方法收集68例为胆道闭锁患儿活体肝移植手术提供移植肝的供者手术资料，分析其取肝术的手术时间、术中出血量情况，术后第1、3、5、7天抽取静脉血检测肝功能及凝血功能，观察术后并发症情况。结果手术时间271～875 min、平均312 min，术中出血量45～210 mL、平均100 mL。术后第1天TB、ALT、AST、国际标准化比值（INR）均高于术前（P＜0．05）。术后第3天后肝功能及凝血功能各指标均有降低。术后并发症共7例（10．3％），其中切口液化3例、腹腔积液2例、肝断面渗血1例、胆漏1例，均经及时处理后恢复。随访5～34个月，全部供者均健康存活，肝脏功能检查均正常，未诉特殊不适。结论胆道闭锁患儿活体肝移植供者取肝手术对供者的手术安全性较高，术后并发症较少，供者身体状况恢复良好。