目的

重型肝炎肝移植手术时机选择。

方法

用原位肝移植联合人工肝技术治疗重型肝炎36 例。

结果

①MELD 评分＜30 组与≥30 分2 组患者1 年存活率有明显差异（77.8%和33.3%，P=0.007）。 ②MELD 评分＜30 分组肝移植病人的并发症发生率明显低于≥30 分组（P=0.012）。 ③MELD 评分＜30 组与≥30 分2 组病人人工肝使用次数、手术持续时间、出血量、输血量、住院费用进行t 检验没有统计学差异。 但MELD 评分≥30 组的日均住院费用明显高于＜30 组（P=0.008）。

结论

MELD 评分＜30 分肝移植预后明显好于≥30 分的重型肝炎患者。

Objective

Analysis on the selection of operative opportunity for severe hepatitis patients treated by liver transplantation operations.

Methods

Thirtysix patients with severe hepatisis were treated by orthotopic liver transplantations.

Results

The patients were differentiated into two groups with MELD grade less than thirty and more than thirty respectively，For one year survival rate and postoperative complications，the former were significantly lower than the latter （77.8% and 33.3%，P=0.007）（P=0.012）.For the operation time，operative haemorrhage，transfusion and total hospitalization costs，there were no significant differences between the two groups of patients.But for the daily hospitalization cost，the former was much lower than the latter （P=0.008）.

Conclusion

For the postoperative prognosis of orthotopic liver transplantations，the patients with MELD grade less than thirty were much preponderant than those with MELD grade higher than thirty.