原位肝移植术后下腔静脉狭窄的原因及防治

The cause, prevention and treatment of stenosis of inferior vena cava after orthotopic liver transplantation

目的 探讨肝移植术后下腔静脉狭窄的原因和防治方法。方法 本组共施行原位肝移植术8例,通过彩超及下腔静脉造影检查证实术后发生下腔静脉狭窄2例。结果 在2例下腔静脉狭窄中,1例经球囊扩张及支架置入术而治愈;另1例病人拒绝手术自动出院。结论 肝移植术后下腔静脉狭窄的重要因素是吻合技术不当,肝脏体积过大,血肿形成,腹水生成,癌肿复发。球囊扩张、支架置入是有效的治疗手段。

Objective To investigate the cause, prevention and treatment of stenosis of inferior vena cava after liver transplantation. Methods Orthotopic liver transplantation was done in 8 cases. Stenosis of inferior vena cava was confirmed by the ultrasonography of color Doppler and phlebography. Results Among 2 cases of stenosis of interior vena cava, one case was cured by transluminal balloon dilatation and stent implantation, the another case refused to operation and discharged from hospital automatically. Conclusion The important factors of stenosis of inferior vena cava are unsuitable anastomotic skill, excessive volume of liver, hematoma, ascites formation and cancer relapse. Transluminal balloon dilatation and stent implantation are an effective therapeutic method and can be used in patients with recurent hepatic carcinoma.