彩色多普勒超声检测移植肝血流变化预测胆道并发症发生的可行性  

Predictive Feasibility of Color Doppler Ultrasonography in the Diagnosis of Biliary Complications After Orthotopic Liver Transplantation by Observing the Vascular Hemodynamic Changes

作　　者：刘景云[1] 黄道中[1] 张青萍[1] 周元媛[1] 朱霞[1] 吴亮[1] 刘健[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉市430030

出　　处：《中国超声医学杂志》2006年第10期768-770,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨肝移植术后彩色多普勒超声检测血流变化预测胆道发生并发症的可行性。方法超声观察125例肝移植患者术后肝脏动静脉血流变化,主要观测血管内径(D),峰值流速(PS),阻力指数(RI),时间平均流速(TAV)。结果肝移植术后,发生胆道并发症者49例,各项指标分别与术后未发现并发症的对照组59例相比:(1)术后30d内肝动脉PS减低,RI增高,2项指标差异均有显著性意义;(2)术后15d内并发症组肝静脉D较细,TAV减低,差异均有显著性意义;(3)两组间门静脉TAV差异无显著性意义,但并发症组中,单纯肝动脉供血不足者13例,门静脉TAV增高,与对照组相比,差异有非常显著性意义;单纯出现排异反应者8例,门静脉TAV减低,与对照组相比,差异有显著性意义。结论超声预测肝移植术后肝动脉供血不足及排异反应导致的胆道并发症是可行的。Objective To explore the predictive feasibility of color Doppler ultrasonography in the diagnosis of biliary complications （BC） after orthotopic liver transplantation. Methods A total of 125 patients after orthotopic liver transplantation underwent colour Doppler flow imaging （CDFI） to observe the vascular hemodynamic changes. Mornitoring parameters included the blood vessel diameter （D）, maximum blood flow velocity （PS）, resistance index （RI） and time-average blood flow velocity （TAV） . Results Of the 125 patients, 49 with BC were compared with 59 orthotopic liver transplantation without BC control group： 1） Hepatic arterial PS was lower and RI was higher than those of the control group （P〈0. 05） within postoperative 30 days; 2） Hepatic venous diameter was smaller and TAV was lower （P〈0. 05） ; 3） There was no difference in portal vein TAV, but 13 of the 49 patients were with poor hepatic artery blood supply, portal vein TAV was significantly higher （P〈0. 01） ; 4） 8 with rejection, the portal vein TAV was lower （P〈0. 05）, Conclusions Ultrasonography has the feasibility to predict BC after liver transplantation due to poor hepatic artery blood supply and rejection.

关 键 词：超声检查 肝移植 血流动力学 胆道并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学]