老年患者肝移植问题的研究

目的 总结老年患者（≥60岁）肝移植的疗效及相关问题。方法 回顾性分析59例≥60岁（i〉60岁组）及500例〈60岁（〈60岁组）接受原位肝移植术患者的临床资料,比较其术前、术中、术后相关数据和1年生存率等。结果 ≥60岁组1年生存率（66％）与〈60组（76％）的差异无统计学意义（P〉0．05）;两组手术时间、术中失血量、住院时间、肝动脉血栓发生率差异无统计学意义（P〉0．05）;≥60岁组急性排斥反应率低于〈60岁组,ICU停留时间、机械辅助通气时间长于〈60岁组,术后感染、脑出血发生率较〈60岁组高。老年患者肝移植术后的主要死因是感染和脑出血。结论 老年患者肝移植疗效满意,但术后并发症发生率较高。

Orthotopic liver transplantation in patients over 60 years old

OBJECTIVE: To investigate the outcome and relative problems of patients over 60 years old underwent orthotopic liver transplantation (OLT). METHODS: Data of patients over 60 years old (>or= 60 years old group, n = 59) patients recipients who were 18 to 59 years old (< 60 years old group, n = 500) were reviewed retrospectively. RESULTS: Overall patients survival at 1 year was not significantly different among >or= 60 years old group (66%) and < 60 years group (76%). There were no differences in the operation time, the quantity of blood lost during operation, the days of hospitalization and the incidence of hepatic artery thrombosis between the two groups. The incidence rate of acute rejection reaction in >or= 60 years old group was lower. Both the duration of staying in intensive care unit and the time of using ventilator in >or= 60 years old group were longer than the other group. Moreover, the incidence rates of infection and intracerebral hemorrhage were higher in >or= 60 years old group, which were the primary causes of death in this group. CONCLUSION: Even though the complications were higher, recipients over 60 years old underwent OLT have more excellent 1 year survival.