彩色多普勒超声在动态监测移植肝及其并发症中的应用

目的探讨彩色多普勒超声在动态监测肝移植术后血流动力学变化及并发症诊治中的应用价值。方法回顾我中心107例原位肝移植术后应用彩色多普勒超声资料,汇总后行统计学分析。结果肝移植术后早期门脉流速较正常对照组升高,而肝动脉流速降低,后逐渐恢复正常。107例中发现肝动脉血栓形成2例(1.87%),肝动脉狭窄5例(4.67%),门脉血栓形成3例(2.80%),肿瘤复发7例(6.54%),诊断为急性排斥反应18例次(16.82%),慢性排斥反应10例次(9.34%),胸腔积液105例(98.13%),腹腔积液65例(60.74%),假性动脉瘤1例,胰漏1例,胆道感染4例(3.74%),胆道狭窄4例(3.74%),胆漏5例(4.67%),胆总管结石1例。结论彩色多普勒超声在动态监测肝移植术后血流动力学变化及并发症诊治中具有重要的临床意义。

Application of color doppler ultrasound in monitoring liver graft dynamically and diagnosis and treatment of complications following liver transplantation

Objective To investigate the value of color doppler ultrasound in monitoring the hemodynamics of liver graft dynamically and diagnosis and treatment of complications following liver transplantation.Methods The color doppler ultrasound data of 107 cases of liver transplantation after operation in our center were retrospectively reviewed,then gathering the data and statistical analysis were made.Results The velocity of the portal vein flow was increased but that of the hepatic artery was decreased as compared with those in control group at the early phase after the transplantation,and then these indexes returned to normal gradually.Among the 107 cases,hepatic artery thrombosis occurred in 2 cases,hepatic artery stenosis in 5 cases,portal vein thrombosis in 3 cases,recurrence of carcinoma in 7 cases,acute rejection in 18 cases,chronic rejection in 10 cases,pleural effusion in 105 cases and abdominal effusion in 65 cases,hepatic pseudoaneurysm in 1 case,pancreas leakage in 1 case,bile duct infection in 4 cases,bile duct stricture in 4 cases,bile leakage in 5 cases and calculus of common bile duct in 1 case.Conclusion Color doppler ultrasound has an important clinical significance in monitoring the hemodynamics of liver graft and diagnosis and treatment of complications following liver transplantation.