彩色多普勒超声评价肾动脉血流变化在肝移植术后早期急性肾功能障碍中的应用  

Assessment of the blood changes of renal arterial in acute renal failure after orthotropic liver transplantation with color Doppler ultrasound and the corresponding clinical value

作　　者：邱少东[1] 许寅宏[1] 曾碧丹[1] 

机构地区：[1]广州医学院第二附属医院超声科,510260

出　　处：《实用医学杂志》2009年第23期3951-3953,共3页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:A2006296)

摘　　要：目的:应用彩色多普勒超声(CDFI)检查原位肝移植(OLT)术后肾脏的形态及血流动力学的变化,重点探讨肾动脉阻力指数(RI)在肝移植术后对肾功能评价的临床应用价值。方法:19例原位肝移植患者,分别于术后1、7、30 d、6个月观察肾脏大小,回声,以及肾叶间动脉的血流参数,同时测定血清肌酐(Cr),并与正常对照组进行对照。结果:肝移植患者术后早期肾叶间动脉RI与术前相比均升高(P<0.05),至术后6个月可恢复至术前水平(P>0.05)。肝移植术后8例发生急性肾衰,其中A组(术前Cr<133μmol/L)3例(25%),B组(术前Cr≥133μmol/L)5例(71%),且B组与A组比较肾动脉RI及血清Cr水平均明显增高,差异具有统计学意义(P<0.05)。结论:术后肾动脉RI的增高以及术前Cr水平升高可提示存在肾功能不全,并能观察其疗效及判断其转归,具有重要的临床应用价值。Objective To evaluate the clinical value of the renal arterial resistance index （RI） for renal dysfunction with color Doppler ultrasound to exam the renal shape and homodynamic changes after orthotropic liver transplantation （OLT）. Methods Renal size, internal echo and resistance index （RI） changes of renal arterial were measured before surgery and 1 day, 7 days, 30 days and 6 months after orthotropic liver transplantation by using color Doppler ultrasound and serum creatinine detection in 19 patients. Meanwhile the same parameters were measured in controls. Results RI of renal arterial raised after OLT （P 〈 0.05）, restored to normal after OLT in 6 months （P 〉 0.05）. Acute renal failure have found 8 cases after liver transplantation. There were 3 cases in the group A （Cr 〈 133 μmol/L before operation）（25%）, and There were 5 cases in the group B （Cr≥133 μmol/L before operation）（71%）. The RI and Cr of group B was increased observably than group A. The difference was observably also （P 〈 0.05）. Conclusion The increased RI after operation and the higher Cr before operation may indicate renal failure. So it can be used to observe the curative effect and judge the results after orthotropic liver transplantation, it have important clinical application value.

关 键 词：肾功能衰竭 急性 超声检查 彩色 多普勒 肾血流 原位肝移植 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.3[医药卫生—诊断学]