介入放射学诊疗肝移植后血管并发症的初步探讨

Intervenioal method in diagnosis and treatment of vascular complication after liver transplantation

目的 评价介入放射学手段在诊断和处理肝移植后血管并发症的价值。方法 对通过介入方法诊断的 7例肝移植术后血管并发症病例进行了回顾 ,对该 7例病例相关生化指标、血管造影的表现进行了分析。结果 7例中 6例在操作技术上获得了成功。其中 3例腔静脉狭窄者术后临床症状和肾功能改善满意 ,其中 1例超过 2 0个月 ,另 2例由于其他死亡原因分别在术后 10d和 2 9d死亡。肝动脉并发症介入术后肝功能未得到明显改善。结论 血管造影对肝移植术后血管并发症的诊断具有重要的价值 ,下腔静脉狭窄的介入处理效果令人鼓舞。介入处理移植后肝动脉并发症的疗效受到确诊时间等多种相关因素的影响 ,有待进一步探讨。

Objective To evaluate the role of interventional method in the diagnosis and treatment of vascular complication after liver transplantation. Methods Seven patients (3 vena cava stenosis,1 hepatic artery stenosis, 2 hepatic artery thrombosis, and 1 hepatic artery pseudoaneurysm ) with vascular complication after liver transplantation had been studied retrospectively, including the correlative biochemistry data and angiographic signs. Results Among the 7 patients,6 patients had been successfully treated by interventional radiology procedure. The technical success rate was 85.56%. The renal functions of 3 patients with vena cava stenosis who had been treated by angioplasty improved satisfactorily. The survival time after this intervention of these 3 patients ranged from 10 days to 20 months. 1 patient still lived 20 months after the intervention, 2 died of other complications beside caval stenosis within one month after the intervention. The hepatic function of the 4 patients with hepatic artery complications treated by interventional procedures had not been redressed. Conclusion Angiography played an important role in diagnosing the hepatic vascular complication after liver transplantation. The result of interventional radiology treatment of vena cava stenosis was encouraging.