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儿童心脏死亡捐肝移植治疗儿童肝糖原累积症
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Abstract:
目的:总结儿童心脏死亡捐肝治疗儿童肝糖原累积症的体会。方法:供者为男孩,3岁8个月,因严重病毒性脑炎致脑死亡继发心脏死亡行器官捐献;受者为男孩,4岁2个月,体重15 kg,生长发育迟缓,因肝糖原累积症继发肝功能不全、严重低血糖。手术采用经典原位肝移植术式,供肝热缺血时间6 min,冷缺血时间约180 min,术中留置T管和经胃空肠造瘘管。术后密切监测生命体征和移植肝功能,同时给予抗感染、改善微循环及营养支持等处理,采用他克莫司 + 甲泼尼龙片二联免疫抑制方案。结果:受者手术时间约420 min,其中无肝期约55 min,术中出血量400 ml。患儿术后2 h血糖恢复正常,6 h清醒并拔除气管插管,24 h后开始经胃空肠造瘘管进行肠内营养,术后7天下床,移植肝功能恢复正常,术后18天痊愈出院。术后
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