肝移植术后肝动脉血栓的介入溶栓治疗分析

目的 探讨肝移植术后肝动脉血栓(HAT)形成后介入溶栓治疗的价值.方法 对160例同种异体肝移植病例,术后采用彩色多普勒超声定期检测肝动脉血流,对怀疑肝动脉血栓形成者行肝动脉造影,确诊4例,均即刻行介入溶栓治疗,其中2例留置肝动脉导管反复持续溶栓治疗.结果 3例介入溶栓治疗后,肝动脉均再通,其中1例因血栓再形成而多次溶栓,2例发生腹腔内少量出血,均经保守治疗痊愈.1例因溶栓失败及腹腔内出血行再次肝移植.结论 肝动脉介入溶栓治疗为HAT的有效方法,留置肝动脉导管持续药物泵入溶栓效果显著.

Intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation

Objective To explore the clinical value of intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation. Methods Routine color doppler imaging (CDI) was used to detect hepatic artery thrombosis (HAT) after liver transplantation in 160 cases. Suspected patients were further confirmed by immediate angiography. Four cases of HAT were diagnosed and treated by intra-arterial thrombolysis. Two cases received repeatable transcatheter hepatic arterial thrombolysis with a low dose of urokinase. Results Hepatic artery recanalization was achieved in 3 cases. Among the 3 cases, multiple HAT occurred in 1 case, intra-arterial thrombolysis was successfully completed in the end. Two cases had intra-abdominal hemorrhage, which was cured by conservative treatment. One case received retransplantation because of interventional thrombolysis failure and intra-abdominal hemorrhage. Conclusion Intra-arterial thrombolytic therapy may be a promising method in the treatment of HAT. Transcatheter hepatic arterial thrombolysis shows a significant result.