肝动脉阻力指数与肝移植术后胆道并发症的相关性分析

Correlation between Hepatic Artery Resistence Index and Biliary Complications after Liver Transplantation

目的:通过彩色多普勒超声检测肝动脉阻力指数变化,评价其对肝移植术后胆道并发症的预测价值。方法:用彩色多普勒超声观察107例肝移植患者术后肝脏血流变化,将肝动脉阻力指数进行分类分析。结果:肝移植术后,发生胆道并发症者33例。出现低阻力指数者共44例,包括首次检查RI≤0.50、随访2次以上发现RI≤0.50及RI较首次检查降低>0.30者,其中30例术后发生胆道并发症。低阻力指数者胆道并发症发生率明显增高(P<0.01),阻力指数正常者胆道并发症发生率明显减低(P<0.01),高阻力指数者胆道并发症发生率与整体发生率差异无统计学意义(P>0.05)。结论:肝动脉低阻力指数与胆道并发症有明显的相关性,超声可预测肝移植术后肝动脉供血不足导致的胆道并发症。

Objective：To study the predictive value of hepatic artery resistance index （HARI） by color Doppler ultrasonography （CDUS） in the evaluation of biliary complications after orthotopic liver transplantation. Methods： 107 patients after orthotopic liver transplantation were examined with CDUS flow imaging to observe the hemodynamic change of the hepatic artery vascular system. The HARI of each patient was categorized and analyzed. Results： 33 of 107 patients suffered from biliary complications after sugery. Altogether there were 44 patients with low HARI, including HARI ≤0.5 at the first study, HARI 40.5 for 2 times in the subsequent follow-up study and HARI lower than the first study exceeded 0.3. Of these 44 patients, there were 30 patients suffered from biliary complications post-operatively. The incidence of biliary complications in patiens with low HARI was obviously increased （P〈0.01）. Of the patients with normal HARI,the incidence of biliary complications was markedly decreased （P〈0. 01 ）. Yet, no statistical difference in the morbidity of biliary complications was existed between patients with high HARI and the whole group （P〉0.05）. Conclusion：Biliary complication after liver transplantation was obviously relevant to low HARI. Biliary complications due to inadequate hepatic artery blood supply could be predicted by HARI measurement with CDUS.