移植肝肝静脉血流变化的彩色多普勒超声检测

The clinical value of Color Doppler Ultrasonography in monitoring hemodynamics change of hepatic vein after liver transplantation

目的探讨彩色多普勒超声检测肝移植术后肝静脉血流动力学变化,早期诊断术后肝静脉及下腔静脉并发症和评价肝功能的临床价值。方法67例原位肝移植术后患者行彩色多普勒超声检查,观察肝移植患者肝实质、血管、胆管声像图改变和肝静脉血流动力学变化时。对54例无肝静脉及下腔静脉并发症患者,记录血浆凝血酶原时间(PT)、血清总胆红素(Tbil)、白蛋等相关指标,观察有无腹水、肝性脑病,按Child-Pugh评分分级,并且与肝静脉血流改变对照。结果67例原位肝移植术后,下腔静脉栓塞5例,肿瘤复发伴下腔静脉、肝静脉狭窄8例。54例无肝静脉及下腔静脉并发症患者肝静脉血流改变随着肝功能Child-Pugh分级变化改变明显,具有统计学意义(P<0.005)。结论彩色多普勒超声检测对肝移植术后肝静脉、下腔静脉并发症诊断和肝功能评价有重要临床意义。

Objective To discuss the clinical value for diagnosing hepatic vein and interior vena cava complications and evaluating hepatic function after liver transplantation, color Doppler Ultrasonography were used in the examination of hemodynamic change of hepatic vein after liver transplantation.Methods Sixtyseven patients after Orthotopic liver transplantation were examined with color Doppler ultrasonography to observe the ultrasonographic change of hepatic parenchyma, vessels, bile ducts and hemodynamic change of hepatic vein . Fifty - four patients without complications were recorded correlated index PT, Tbil, albumin, ascites and hepatic encepha- lopathy, and evaluated hepatic function according to Child - Pugh grade variables, and contrasted with the hemodynamic change of hepatic vein after Orthotopic hver transplantation. Results Five patients complicated with interior vena cava thrombosis. Eight patients complicated with hepatic vein stenosis following tumor recurrence. Univariate analysis showed hepatic function Child- Pugh grade variables correlated significantly with the hemodynamic change of hepatic vein after Orthotopic liver transplantation for fifty - four patients without hepatic vein and interior vena cava complications（ P 〈 0.005）. Conchusion Color Doppler ultrasonography have valuable clinical significance for diagnosing hepatic vein and interior vena cava comphcations and evaluating hepatic function after orthotopic liver transplantation.