目的 探讨原位肝移植术后并发症的诊治经验。 方法 回顾性分析我院16例肝病患者行17例次肝移植术后各种并发症的诊断及治疗方法。 结果 全组手术成功12例次，围手术期死亡5例，死亡原因： 脑出血1例，急性呼吸窘迫综合征（ARDS）1例，急性肾功能衰竭1例，肝动脉血栓1例，急性排斥反应1例。现存活6例，其中1例存活已超过3年。术后并发腹腔内出血3例，脑血管病变2例，ARDS 2例，血管并发症2例，胆道并发症3例，急、慢性排斥反应各2例，急性肾功能衰竭2例。 结论 肝移植围手术期采取合理的防治措施能有效地减少肝移植术后并发症的发生，对肝移植术后并发症的及时诊断和有效治疗是提高肝移植术后成功率的关键。
【Abstract】Objective To study the antitumor activity of HSVtk/CD combinative gene toward human cholangiocarcinoma in vivo. Methods Nude mouse models with transplanted subcutaneous cholangiocarcinoma were constructed and divided into 4 groups randomly, each group had 8 mice. Adenovirus solution free from suicide gene was injected in subcutaneous tumors of each mouse of control group. Adenovirus solution containing cytosine deaminase (CD), thymidine kinase (tk) and HSVtk/CD fusional gene were injected into single suicide gene either HSVtk or CD was transinfected into the tumor cells by injecting viras into subcutaneous tumor of mice of CD gene,tk gene and fused CD and tk gene group respectively. 24 hours after the injection, 5fluorocytosine (5FC) and ganciclovir (GCV) were injected introabdominally in each mouse. Growth of the tumors were monitored.Results Tumor growth of the genetransfection groups was suppressed in different degrees. Compared with the control group, the suppressing rates of the genetransfection groups were 41.2%, 55.7% and 70.0% respectively (P＜0.05). Histological examination showed good tumor growth in the control group, and tumor necrosis in the other 3 groups, particularly obvious in the group transfected with pAd(HSVtk/CD).Conclusion Combinative gene system has a b antitumor effect on cholangiocarcinoma in vivo. But it’s not powerful enough to eliminate tumor thoroughly because of insufficient “Bystander effect”.