中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (5): 913-915.doi: 10.3969/j.issn.1673-8225.2011.05.037

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

肾移植后重症肝炎19例分析

蔡文利，李海霞，邢  利，苗书斋   

  1. 郑州人民医院器官移植科，河南省郑州市  450003
  • 收稿日期:2010-09-28 修回日期:2010-11-11 出版日期:2011-01-29 发布日期:2011-01-29
  • 作者简介:蔡文利★，女，1976年生，河南省郑州市人，汉族，2004年华西医科大学第一临床医学院原四川大学华西医院毕业，硕士，主治医师，主要从事肾内科以及肾移植术前术后管理。 Wenlicai1234@163.com

Serious hepatitis after renal transplantation: A 19-case analysis 

Cai Wen-li, Li Hai-xia, Xing Li, Miao Shu-zhai   

  1. Department of Organ Transplantation, Zhengzhou People’s Hospital, Zhengzhou 450003, Henan Province, China
  • Received:2010-09-28 Revised:2010-11-11 Online:2011-01-29 Published:2011-01-29
  • About author:Cai Wen-li★, Master, Attending physician, Department of Organ Transplantation, Zhengzhou People’s Hospital, Zhengzhou 450003, Henan Province, China Wenlicai1234@163.com

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310

被引次数

1

摘要：

背景：研究认为肾移植后感染肝炎病毒，比术前感染有更为严重的肝损害表现，且有观点认为术前肝炎病毒感染对肾移植术后5年内肾功能影响不大。
目的：分析肾移植后的重症肝炎发病情况和治疗方法。
方法：对19例肾移植后重症肝炎病例进行回顾性分析。治疗包括一般治疗、抗病毒治疗、免疫抑制剂方案调整和人工肝治疗。主要观察患者综合治疗后一般情况、肝功能、血常规及死亡率。
结果与结论：19例重症肝炎患者经过常规治疗和抗病毒治疗，部分应用胆红素吸附治疗，12例应用人工肝治疗患者，精神和神智均有不同程度的好转，胆红素和转氨酶均有一定程度的下降。死亡13例，其中术后感染肝炎病毒的4例全部死亡，3例单纯药物性肝损害患者全部痊愈。结果提示肾移植后重症肝炎死亡率高，对于诊断为重症肝炎患者常规治疗基础上，进行一定的抗病毒治疗和/或人工肝治疗，可使部分患者病情逆转,可能降低死亡率。

关键词: 重症肝炎, 肾移植, 肝炎病毒, 人工肝, 治疗

Abstract:

BACKGROUND: Studies demonstrated that hepatitis virus after renal transplantation has more serious hepatic lesion than preoperative infection, and some views have suggested preoperative hepatitis virus infection has little effect on renal function after renal transplantation within 5 years.
OBJECTIVE: To analyze the incidence and treatment of serious hepatitis after renal transplantation.
METHODS: A total of 19 cases with serious hepatitis after kidney transplantation were retrospectively analyzed. The treatment included general treatment, antiviral therapy, adjustment of immunosuppressant protocol, and artificial liver treatment. General state of health, hepatic function, blood routine and death rate of patients after combined therapy were observed.
RESULTS AND CONCLUSION: Totally 19 cases with serious hepatitis underwent conventional therapy and antiviral therapy, a part of 19 cases treated with bilirubin adsorption, 12 cases treated with artificial liver. Spirit and sanity have different degrees of improvement, and bilirubin and transaminase were decreased to some extent. A total of 13 cases died, including 4 cases died who infected hepatitis virus after operation, 3 cases with simple drug induced hepatic lesion were fully recovered. The results suggested that the death rate of serious hepatitis after renal transplantation is high. Patients treated with antiviral therapy and/or artificial liver based on diagnosis of conventional therapy in patients with severe hepatitis, can reverse patients’ condition, may reduce mortality.

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