彩色多普勒在胰、肾联合移植术后移植体血流监测中的应用价值

Monitoring of Graft Flow with Color Doppler in Simultaneous Pancreas-kidney Transplant Recipients

目的探讨彩色多普勒在胰肾联合移植术后移植体血流监测中的应用价值。方法以18例胰肾联合移植术(SPK)患者为研究对象,于术后第1、3、7天行彩色多普勒检查,记录移植肾脏、胰腺的体积及动静脉血流速度,计算阻力指数(RI),并与30例单纯肾移植术(KT)患者及30名健康对照者的彩色多普勒检查结果进行比较。结果彩色多普勒可清晰显示胰腺、肾脏的形态、大小及血流。SPK患者移植肾脏的形态、体积和动静脉血流速度与KT患者的移植肾相比差异无显著性(P>0.05)。SPK患者术后早期胰腺体积明显大于健康对照者,移植胰腺的动脉血流速度与健康对照者相比差异无显著性(P>0.05),移植胰腺的门静脉频谱呈双向波和三项波等体静脉频谱特征。结论彩色多普勒对SPK后移植体血流监测具有高度敏感性,可用于诊断移植后血管性并发症及评价组织灌注情况。

Objective To evaluate the clinical value of color Doppler in monitoring graft flow in patients who underwent simultaneous pancreas-kidney （SPK） transplantation. Methods Totally 18 patients received color Doppler ultrasonography on day 1, 3, and 7 after SPK. Volumes and arteriovenous velocities of the kidney and pancreas grafts were recorded, and resistance index （RI） was calculated. Results Color Doppler ultrasound clearly displayed the modality, size, and flow of the kidney and pancreas grafts. Compared with the single kidney grafts, the modality, volume , and arteriovenous velocity of kidney grafts in SPK was not significantly different. Although the volume of pancreas graft was remarkably larger than the normal control pancreas early after transplantation, no difference in artery velocity was found between pancreas graft and normal pancreas. The spectrum of the portal vein in pancreas grafts showed the typical spectrum of iliac veins. Conclusion Color Doppler ultrasound is sensitive in monitoring the graft flow of SPK recipients and can be used to identify postoperative vascular complications and evaluate tissue perfusion.