彩色多普勒对移植肝脏的血流动力学监测

Hemodynamics Monitoring of Liver Transplantation with Color Doppler Ultrasound

采用彩色多普勒超声对移植肝血流动力学进行监测 ,了解肝移植前后肝脏血流动力学变化 ,观察与推测血管吻合口的通畅程度 ,寻找与排除并发症的存在 ,进而判断移植肝成活度及预后。就本院近期 6例同种原位肝移植术后的移植肝血流进行检测 ,观察动、静脉吻合口的通畅情况及门静脉与肝动脉血流动力学改善程度。 6例移植肝脏周围未见液性及实性异常回声 ,肝内实质及管道回声与血流方向、速度正常 ;在 2 4个吻合口中 ,5例门静脉吻合口通畅 ,1例门静脉吻合口稍窄 ,局部血流速度稍快 ;12个腔静脉吻合口中 11个吻合口通畅 ,1个下腔静脉肝下段吻合口稍窄 ;6个肝动脉吻合口以远的肝动脉血流速度、阻力指数正常。肝移植是解决门脉高压的根本办法 。

By hemodynamic monitoring of liver transplantation with Color Doppler ultrasound, we observed the hemodynamic changes pre- and post-operatively and the patency of the anastomotic vessels, to detect or exclude the presence of complications, then assess the prognosis. We measured the hepatic blood flow after orthotopic liver transplantation in recent 6 cases. and observed the patency of anastomostic vessels and the hemodynamic improvement of the portal vein and hepatic arteries.The abnormal liquid and solid echoes were not found around the transplantated liver in all 6 cases. The echoes of hepatic parenchyma and tububes were normal. The direction and speed of blood flow were also normal. Five of anastomoses of portal vein in 6 cases were patent. The rest one was a little stenosed, and the speed of local blood flow was a little faster. There were 11 patent ones and 1 mildly stenosed in the 12 anastomoses of inferior venae cavae. The speed index(SI) and resistance index(RI) of hepatic arterial blood flow distal to the anastomoses were all normal. Liver transplantation is the redical therapying of portal hypertension, and the color Doppler ultrasound is the best non-invasived method for monitoring the hemodynamic changes of transplantated liver.