小儿肝移植术后门静脉狭窄球囊扩张治疗的中长期结果  被引量:6

Medium and long-term therapeutic results of percutaneous transhepatic angioplasty for portal vein stenosis fol- lowing pediatric liver transplantation

在线阅读下载全文

作  者:高海军[1] 陈光[1] 王浩[1] 温连芳[1] 杨颐馨[1] 王鹏辉[1] 

机构地区:[1]天津市第一中心医院放射科,300192

出  处:《中华实用儿科临床杂志》2014年第7期554-557,共4页Chinese Journal of Applied Clinical Pediatrics

摘  要:【摘要】目的探讨小儿肝移植术后门静脉狭窄(PVS)介入治疗的中长期结果及治疗意义。方法回顾性分析2008年1月至2012年12月肝移植术后PVS5例患儿资料,男3例,女2例;年龄7个月~8岁,中位年龄2岁10个月。患儿原发病:1例为Carolis病,4例为先天性胆道闭锁。患儿均采用球囊扩张治疗,对患儿临床资料、影像随访资料、介入治疗的并发症和预后等情况进行总结。结果5例肝移植术后PVS患儿球囊扩张治疗均成功,成功率为100%。肝移植术后早期狭窄1例,发生于术后0.5个月,迟发性狭窄4例,发生于术后3~30个月。PVS部位均发生在门静脉吻合口部位,狭窄部位门静脉直径为(2.3±0.6)mm(1.2—3.0mm),狭窄程度为70%~95%。患儿均采用球囊扩张,球囊扩张后狭窄部位的直径为(9±1)mm(8—10mm)(t=32.560,P〈0.05)。扩张前狭窄两端压力梯度为(11.0±3.2)mmHg(8~16mmHg),扩张后狭窄两端压力梯度为(2.2±1.5)mmHg(0~4.0mmHg)(t=8.242,P〈0.05)。术后随访10—66个月,患儿门静脉均通畅,通畅率为100%。结论肝移植术后PVS的介入治疗是一种安全、有效的治疗方法,中长期随访结果通畅率高。Objective To evaluate the medium and long-term therapeutic results of pereutaneous transhepatie angioplasty for portal vein stenosis (PSV) following pediatric liver transplantation. Methods From Jan. 2008 to Dee. 2012,5 eases with PVS after pediatric liver transplantation received pereutaneous transhepatie angioplasty. There were 3 male and 2 female eases ranging from 7 months to 8 year-old with the median age of 2 years and 10 months. The pro- topathy included 1 Carolis disease and 4 congenital biliary atresia. The therapeutic results were monitored by clinical follow-up and imaging examination. The clinical data, imaging examination and therapeutic results were analyzed. Re- sets All interventions were performed successfully,and the treatment efficacy was 100%. One patient was diagnosed with earl-onset PVS at 0.5 month after liver transplantation. Four patients were diagnosed with late-onset PVS at 3 - 30 months after liver transplantation. The prestenotie portal venous average diameter was ( 2. 3 ± 0. 6) mm ( 1.2 - 3.0 mm), the degrees of stenosis were 70% -95%. The poststenotie portal venous average diameter was (9± 1 ) mm( 8 - 10 ram) ( t = 32. 560, P 〈 0.05 ). The prestenotie portal venous average pressure gradient was ( 11.0 ± 3.2 ) mmHg (8 - 16 mmHg), and the poststenotie portal venous pressure gradient was (2. 2 ± 1.5 ) mmHg (0 - 4.0 mmHg) ( t = 8. 242, P 〈 0. 05 ). Postoperative follow-up was 10 - 66 months, the portal veins of all eases were patent, and pateney rate was 100%. Conclusions Pereutaneous transhepatie stent angioplasty is an effective and safe method for treatment of PVS following liver transplantation. Its medium and long-term pateney rates are high.

关 键 词:小儿肝移植 门静脉狭窄 介入治疗 经皮血管成形术 

分 类 号:R726.5[医药卫生—儿科]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象