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晚期酒精性肝硬化患者冠状动脉搭桥术联合肝移植:一例报告

Coronary artery bypass graft combined with liver transplantation in patients with advanced alcoholic liver cirrhosis: A case report.

作者信息

Chai Junwu, Wang Kai, Kong Xiangrong, Pan Cheng, Jiang Wentao, Zhou Wei, Chen Honglei, Xue Fenlong, Zhang Li, Shen Zhongyang

机构信息

Department of Cardiovascular Surgery, Tianjin First Central Hospital, Tianjin Clinical Research Center for Organ Transplantation, Tianjin, 300074, P.R. China.

Department of Liver Transplantation, Tianjin First Central Hospital, Tianjin 300192, P.R. China.

出版信息

Exp Ther Med. 2020 May;19(5):3197-3202. doi: 10.3892/etm.2020.8594. Epub 2020 Mar 11.

Abstract

Performing cardiothoracic surgery on patients with advanced liver failure and liver cirrhosis is high-risk for patients. Coronary artery bypass grafting is the most effective treatment for patients with liver failure that is complicated with severe coronary heart disease, and who cannot be treated using coronary stent intervention. In the current study, one case of coronary artery bypass grafting combined with liver transplantation was assessed, with the patient exhibiting advanced alcoholic liver cirrhosis. A coronary artery bypass graft was performed to relieve angina pectoris. Following surgery, wound exudation, secondary infection, liver failure, pleuroperitoneal fluid leakage, hypoproteinemia and other adverse treatment results occurred, and the chest wound did not heal. Allograft liver transplantation was subsequently performed and, following surgery, the chest wound healed gradually after debridement, and the patient recovered.

摘要

对晚期肝衰竭和肝硬化患者进行心胸外科手术对患者来说风险很高。冠状动脉旁路移植术是治疗合并严重冠心病且无法采用冠状动脉支架介入治疗的肝衰竭患者的最有效方法。在本研究中,评估了1例冠状动脉旁路移植术联合肝移植的病例,该患者患有晚期酒精性肝硬化。进行冠状动脉旁路移植术以缓解心绞痛。术后出现伤口渗出、继发感染、肝衰竭、胸膜腔和腹腔积液、低蛋白血症等不良治疗结果,胸部伤口未愈合。随后进行了同种异体肝移植,术后经清创后胸部伤口逐渐愈合,患者康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa4d/7132228/0807ea6ced65/etm-19-05-3197-g00.jpg

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