体外门-体静脉无泵转流在背驼式原位肝移植术中的应用

目的 探讨背驼式原位肝移植术中采用体外门-体静脉无泵转流的临床效果。方法 4例行背驼式原位肝移植患者，肠系膜下静脉属支插管经体外硅胶管(充满肝素盐水)与颈内静脉或锁骨下静脉插管相接，在阻断门静脉后开通肠系膜下静脉插管，门静脉血从体外无泵转流管流入上腔静脉，观察转流前后肠道瘀血、门静脉压、血压、脉搏等变化情况。结果 门静脉阻断后肠道明显瘀血、肿胀，门静脉压力明显升高。血压、脉搏有不同程度的波动，无泵门静脉转流开放后，肠道瘀血、肿胀明显好转，门静脉压力逐渐恢复正常水平。血压、脉搏恢复正常。结论 背驼式原位肝移植术中体外门-体静脉无泵流具有方便、经济、实用等优点，具有良好的临床效果。

Application of pumpless portosystemic bypass in clinical piggyback liver transplantation

Objective:To investigate the effect of pumpless portosystemic bypass in clinical piggyback liver transplantation.Methods:After catheterized inferior mesenteric vein, the silastic catheter (filled with heparin saline) was connected with the catheterized tube of internal jugular vein or subclavian vein in four piggyback liver transplantation patients. The channel was opened after the portal vein was occluded. The portal vein blood poured into the superior vena cava through the pumpless channel. The changes of mesenteric congestion, portal vein pressure, blood pressure and pulse were observed.Results:During the occlusion of portal vein, the portal vein pressure was increased greatly, the intestine was congested and swelled obviously and the blood pressure and pulse fluctuated gently. After the pumpless bypass opened, intestinal congestion and swell were abated markedly, the portal pressure, blood pressure and pulse gradually returned to normal range.Conclusions:Pumpless portosystemic bypass shows a great effect on clinical piggyback liver transplantation. It is a feasible and economical method.