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肝移植术后大量腹水患者的生长抑素治疗

Somatostatin Therapy in Patients with Massive Ascites After Liver Transplantation.

作者信息

Lee Ting-Ying, Fan Hsiu-Lung, Wang Chia-Wen, Hsieh Chung-Bao, Chen Teng-Wei

机构信息

Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Ann Transplant. 2019 Jan 1;24:1-8. doi: 10.12659/AOT.911788.

Abstract

BACKGROUND Patients with massive ascites (MA) after liver transplantation (LT, defined here as daily ascitic drainage more than 1000 ml per day for more than 7 days after liver transplantation) are at increased risks of infection, hypoalbuminemia, graft loss, and even mortality. The aim of this retrospective cohort study was to investigate the effects of somatostatin on patients with MA after LT. MATERIAL AND METHODS Twenty-eight patients with liver cirrhosis or hepatocellular carcinoma who underwent LT complicated by MA postoperatively were included. Ten participants were receiving somatostatin therapy. The postoperative course and adverse drug effects were investigated. Daily postoperative ascitic drainage and urine output were also recorded and compared to those in the non-somatostatin group. RESULTS The somatostatin group had significantly less ascites drainage after LT compared to the non-somatostatin group (p=0.002). Urine output was significantly increased after somatostatin administration (p<0.001). No serious adverse effects influencing graft function or fatal complications occurred after somatostatin therapy. CONCLUSIONS Somatostatin treatment is beneficial for the management of MA after liver transplantation.

摘要

背景

肝移植后出现大量腹水(MA,在此定义为肝移植后7天以上每天腹水引流量超过1000毫升)的患者发生感染、低蛋白血症、移植物丢失甚至死亡的风险增加。这项回顾性队列研究的目的是探讨生长抑素对肝移植后大量腹水患者的影响。材料与方法:纳入28例因肝硬化或肝细胞癌接受肝移植术后并发大量腹水的患者。10名参与者接受生长抑素治疗。对术后病程及药物不良反应进行调查。记录术后每日腹水引流量和尿量,并与非生长抑素组进行比较。结果:与非生长抑素组相比,生长抑素组肝移植后腹水引流量显著减少(p=0.002)。使用生长抑素后尿量显著增加(p<0.001)。生长抑素治疗后未出现影响移植物功能的严重不良反应或致命并发症。结论:生长抑素治疗有利于肝移植后大量腹水的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/6327785/457aa1227e56/anntransplant-24-1-g001.jpg

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