肝动脉舒张期血流在预测肝移植术后肝动脉血栓形成中的意义

Value of absent or reversed diastolic flow in predicting hepatic artery thrombosis after liver transplantation

目的 回顾性分析肝动脉舒张期异常血流状况在预测肝移植术后肝动脉血栓形成中是否有意义。方法 对 2 0 0 0年 8月至 2 0 0 3年 6月间 ,在我院接受原位肝移植术的 5 4例术后可测及肝动脉信号患者的多普勒超声检查结果及其临床资料行回顾性分析。根据肝动脉舒张期的血流状况将探测结果分为 3类 :舒张期正向血流 ,舒张期反向血流和舒张期无血流信号。同时对所有病例的门静脉血流状况进行多普勒分析。结果 5 4例中12例出现舒张期异常血流 ,其中 4例表现为舒张期反向血流 ,8例表现为舒张期无血流信号。 12例中 1例有肝动脉吻合口狭窄 ,无出现肝动脉血栓形成者。所有病例的门静脉血流未见异常。结论 肝移植术后早期肝动脉舒张期无血流或反向血流与肝动脉血栓形成之间没有相关性 ,肝动脉舒张期无血流或反向血流不能作为预测肝动脉血栓形成的判定指标。

Objective To probe the value of absent or reversed diastolic flow in hepatic artery shown by Doppler sonography of recently transplanted liver in predicting subsequent hepatic artery thrombosis.Methods The records of 54 liver transplantations performed were retrospectively reviewed.The first Doppler study of every case was done within 24 h after transplantation and subsequently reviewed.Findings were categoried into one of three patterns: forward flow,no flow and reversed flow throughout diastole.Meantime,the flow status of portal vein of every case was studied by Doppler sonography.Results Of 54 liver transplants, 12 had aberrant diastolic flow in the hepatic artery after liver transplantation.Four had reversed flow and 8 showed no flow in diastole.In this group of 12 transplants,hepatic artery thrombosis was not developed.Conclusions Reversed or absent diastolic flow in hepatic artery of a recently transplanted liver has no correlation with subsequent hepatic artery thrombosis.