应用彩色多普勒超声观察活体肝脏移植供者围手术期血流变化及并发症的临床研究  

Relationship Between Hemodymamic Changes in Living Donor Liver Transplantion in Early Perioperative and Complication Using Color Doppler Flow Imaging:Clinical Study

作　　者：唐缨[1] 胡翔宇[1] 何恩辉[1] 武红涛[1] 毛鹏[1] 王玉红[1] 沈中阳[1] 

机构地区：[1]天津第一中心医院器官移植中心B超室,天津市300192

出　　处：《中国超声医学杂志》2008年第7期633-635,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用彩色多普勒观察正常人在捐献部分肝脏后的血流动力学变化、脾脏大小、腹水情况及并发症的发生,以进一步提高供体的安全性。方法以50例正常肝脏捐献者为研究对象,(1)分别于供体手术前与手术后测量门静脉、肝动脉、肝静脉、脾脏大小并比较;(2)将切除右半肝供体按是否保留肝中静脉分组,比较血流参数。结果(1)供者手术后门静脉流速较术前升高(P<0.01);肝动脉、肝静脉流速与手术前相比无显著性差异(P>0.05);(2)本组右半肝供体包含肝中静脉的供者与不包含肝中静脉供者比较右半肝切除术后门静脉血流有显著性差异(P<0.01)。(3)供者手术后32例脾脏厚度较手术前增增厚。26例出现一过性腹水,1例出现门静脉血栓形成(经手术证实)。结论彩色多普勒超声检查可直观地反映供体术后血流动力学变化,是鉴别肝脏切除后生理性或病理变化的良好方法。Objective To explore the color doppler flow imagine for observing the hemodynamic changes, spleen size, ascites and complications of the living donor after hepatectomy using color Doppler flow imaging （CDFI）. Methods Fifty cases with living donor liver transplantation were reviewed. 1. The blood flow velocity of portal vein, hepatic artery, hepatic vein, and the spleen size before and after donor hepatectomy were measured, and compared. 2. Fifty cases with living donor liver transplantation were divided into two groups according to whether the middle hepatic vein was included in the graft or not, and compared the parameters of portal vein blood flow of the donors were compared. Results 1. Postoperative blood flow velocity in the portal vein of the donors was significantly increased compared with the preoperative （P〈 0.01 ） .There were no statistically significant differences in postoperative blood flow velocity of the hepatic artery and hepatic vein compared with the preoperative （P〉0. 05）. 2. Blood flow in the portal vein of donors who underwent right leaf hepatectomy, was significantly different between the two groups （with or witbout middle bepatic vein） （P〈0. 01） 3. Of the 50 patients, spleen tumescence occurred in 32 eases, and ascites in 26 cases. Portal vein tbrombosis occurred in 1 ease confirmed by operation. Conclusions CDFI is a good technique for identifying physiological and pathological changes after living donor hepatectomy.

关 键 词：彩色多普勒 活体肝移植 供者 并发症 

分 类 号：R657.3[医药卫生—外科学]