彩色多普勒血流显像对肝移植术后监测的应用价值  

APPLICATION OF BEDSIDE COLOR DOPPLER FLOW IMAGE IN ORTHOTOPIC LIVER TRANSPLATATION

作　　者：蔡叶萍[1] 高晓军[1] 曲虹[1] 娜仁图戈[1] 蔡振刚[1] 宋涛[1] 张博[1] 

机构地区：[1]大连市友谊医院,大连116001

出　　处：《肝胆外科杂志》2008年第6期426-429,共4页Journal of Hepatobiliary Surgery

摘　　要：目的探讨彩色多普勒血流显像技术在移植肝术后检测中的应用价值。方法对38例肝移植术后患者行床旁彩色多普勒血流显像超声检查,观察移植肝实质及周围回声变化及肝动、静脉系统的血流动力学参数改变。结果38例移植肝中3例(7.8%)肝实质回声增强或肝包膜下见部分大小不一的低回声灶。血流动力学变化:2例(5.2%)肝动脉血流流速减慢,呈低速高阻型,;5例(13.1%)门静脉流速增快;1例(2.6%)肝静脉呈单向波。5例(13.1%)胆总管腔显示不清;11例(28.9%)先后发生排斥反应;1例(2.6%)肝动脉血栓形成(HAT);6例(15.8%)门静脉吻合口狭窄;3例(7.8%)门静脉血栓形成;30例(78.9%)于肝周及胸腹腔有少量积液。结论:彩色多普勒血流显像技术应用于移植肝术后检测其物理形态及血流动力学变化对早期发现肝移植排异反应及并发症具有重要的临床应用价值。Objective To evaluate the value of color Doppler flow image in the orthotopic liver transplantation. Methods 38patients of orthotopic liver transplantation were examined by CDFI at bedside to observe the change of liver parenehyma, the hemodynamic parameter of hepatic artery and portal vein, and bile duct＇s sonogram. Result In 38 patients, there were 3 patients （7.8%） with liver parenchyma echo enhancement in liver parenchyma or attenuate under Glisson capsule. Homodynamie changed. The velocities of liver artery were decreased in 2 patients （5.2%） , and the blood flow spectra were low-velocity and high-resistance. The velocity of portal vein was increased in J patients （ 13.1% ）. 1 patient （2.6% ） had unidirectional wave of the hepatic vein. J patients＇ common bile duct caves didn＇t display. 11 patients had rejection reactions early or late, and hepatic artery thrombus （HAT） occurred in 1 patient （2.6% ）. The hepatic vein＇s anastomotic stoma of 6 patients （15.8%） were narrow. 3 patients had hepatic vein thrombus. 30 patients （78.9%） had a little hydrops around their livers and in pleuroperitoneums. Conclusion Color Doppler flow image is valuable for assessing the reject reaction and early diagnose of complication of OLT by observing the change of liver parenehyma and the homodynamic parameter of HAPV or HV.

关 键 词：原位肝移植 彩色多普勒 血流显像 

分 类 号：R575[医药卫生—消化系统]