肝移植治疗乙肝相关性肝衰竭的早期疗效观察.docVIP

肝移植治疗乙肝相关性肝衰竭的早期疗效观察 　　摘要： 目的 观察乙肝相关性肝衰竭患者接受同种异体原位肝移植（OLT）后的早期效果。方法 对34例接受肝移植的乙肝肝衰竭患者进行随访，观察患者术后生存情况及并发症。结果 本组34例患者围手术期（术后30d）内死亡2例，1年生存率91.18%（31/34）。术后早期并发症包括：感染、精神症状、排斥反应、急性肾损伤、急性呼吸窘迫综合症、消化道出血和移植物抗宿主病。远期并发症包括：胆道并发症、乙肝复发和机会性感染。结论 肝移植是治疗乙肝相关性肝衰竭的有效手段。 　　关键词：肝移植；肝衰竭 　　Abstract：Objective To explore the characteristics and diagnosis thinking of treating patients of acute non traumatic abdominal pain in emergency surgery department of primary hospital. Methods Retrospectively analyze the clinical data of 220 cases of acute non traumatic abdominal pain diagnosed in our hospital from October 1， 2013 to February 1， 2015 in emergency surgery department. Results The patients according subject were divided into 162 cases （73.6%） of surgical abdominal pain， 30 cases （13.6%） of internal medicine abdominal pain， 15 cases （6.8%） of gynecologic abdominal pain and 13 cases （6%） of other types of abdominal pain . According to the cause of disease， the front four high incidence rate of abdominal pain was acute appendicitis， urinary calculus， biliary diseases and acute gastroenteritis， respectively 62 cases， 49 cases， 35 cases， 18 cases， accounting for 74.5% of the total numbers. 2 cases were misdiagnosed， misdiagnosis rate was 0.9%. There were 0 deaths. The common auxiliary examination included blood examination， routine urine examination， stool routine examination， biochemical examination and blood coagulation function examination， abdominal ultrasound， X-ray examination， electrocardiogram， abdominal CT examination. Conclusion Primary surgeon must have rigorous thought in diagnosis of diseases and solid treatment technology， be good at changing the traditional thinking way of pain for evidence-based thinking， make the serious patients with acute abdominal pain prejudged early and timely and immediately give a reasonable treatment to avoid delay an illness. 　　Key words：Orthotopic liver transplantation；Liver failure 　　由重型肝炎导致的肝衰竭，在西方主要因为药物等中毒因素导致爆发性肝衰竭，国内多因为肝炎病毒尤其是乙型肝炎病毒（HBV