The Clinical Study Of Portal Vein Bleeding And Double Perfusion Flushing Improved The Incidence Of PRS And The Recovery Of Liver Function

Objective:1、 To investigate whether portal vein bleeding and double perfusion flushing in orthotopic liver transplantation can reduce the risk factors of Post-reperfusion syndrome(PRS)and reduce the incidence of PRS.2、 To explore whether this method has a positive effect on the early recovery of liver function after surgery.Methods:66 cases of orthotopic liver transplantation patients were divided into three groups。group A :19 patients accepted 1500 ml albumin liquid infusion and portal vein bleeding;group B:27 patients accepted 2500 ml albumin liquid infusion and portal vein bleeding;group C:20 cases,as the control group using orthotopic liver transplantation(OLT),accepted 1500 ml albumin liquid infusion,except portal vein bleeding.The observation time points were designed as follows: the moment before open portal vein(T1),the moment when the donor liver leaked the first fluid from the subhepatic postcava after perfusion of portal vein blood(T2),and the moment portal vein bleeding of 200ml(T3).Abstract portal venous blood of the receptor at T1,Abstract the first liquid from subhepatic postcava after perfusion of the portal vein at T2,Abstract the liquid from subhepatic postcava after perfusion of 200 ml portal vein blood at T3.Group B : Abstract receptor postcava blood before portal venous perfusion.Conduct biochemical test and blood gas analysis for the blood samples and compare different point samples p H values,K ion,Lac,BE.The changes of heart rate and blood pressure during operation and the recovery of liver function and coagulation function on day 1,3 and 5 after operation were observed.Result:The incidence of PRS in the experimental group was 0.The physicochemical property of portal vein blood was better than that of the perfusion fluid in donor liver,the difference is statistically significant(P <0.05).The potassium ion in donor liver liquid of group B was lower than that of group A,with statistical significance(P<0.05),but there were no statistically significant differences in Lac,PH and BE.After portal vein perfusion,the physicochemical property of T3 blood were significantly better than that of T2 blood,with statistical significance(P<0.05).There was no significant difference in physicochemical property between portal vein blood and postcava blood(P>0.05).There was no statistical significance in the recovery of AST,ALT,total bilirubin,direct bilirubin and PT between group A and group C(P>0.05).The PTA in group A was lower than that in group C,with statistical significance(P<0.05).Conclusion:1、Portal vein bleeding based on postcava retrograde perfusion can greatly reduce donor liver perfusion fluid,and reduce the inflammatory factors and vasoactive substances produced by IRI in liver,and effectively reduce the incidence of PRS in OLT.It has no effect on the recovery of postoperative liver function and coagulation function,but can only make the total bilirubin level lower.2 、 During portal vein occlusion,the physicochemical property of blood containing acidic substances produced by gastrointestinal congestion are basically the same as those of postcava,which has little effect on the overall internal environment.3、Compared with the single perfusion,the double perfusion can further reduce the potassium ions into the systemic circulation,but there is no difference in Lac,BE,etc.